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General NPI Number Information
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NPI Number | 1184824542
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Entity Type | Individual
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Provider Name | MARK JON PAMER D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 537 NW LAKE WHITNEY PL STE 103
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-1620
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Country | US
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Telephone | 772-785-5864
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Fax | 772-344-2555
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Provider Business Mailing Address
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Address Line | 537 NW LAKE WHITNEY PL STE 103
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-1620
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Country | US
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Telephone | 772-785-5864
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Fax | 772-344-2555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | T4814
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | OS9475
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | OS9475
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | T4814
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License Number State | TX
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