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General NPI Number Information
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NPI Number | 1548252364
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Entity Type | Individual
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Provider Name | MARK DAVID SURAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 12271 US HIGHWAY 301 N
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City | PARRISH
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State | FL
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Zip | 34219-8410
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Country | US
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Telephone | 941-776-4050
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Fax | 941-776-4057
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Provider Business Mailing Address
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Address Line | 700 8TH AVE W STE 101
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City | PALMETTO
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State | FL
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Zip | 34221-4737
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Country | US
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Telephone | 941-776-4008
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Fax | 941-845-4963
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 016-003659
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000627A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PO1633
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License Number State | FL
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