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General NPI Number Information
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NPI Number | 1750358099
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Entity Type | Individual
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Provider Name | MARK PERNI DO
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Gender | Male
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 15100 RESCUE WAY
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City | CLEARWATER
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State | FL
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Zip | 33762-3502
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Country | US
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Telephone | 727-535-1437
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Fax | 727-535-4190
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Provider Business Mailing Address
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Address Line | 24740 ENERGY HWY
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-8570
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Country | US
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Telephone | 912-659-1544
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS008592L
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License Number State | PA
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