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General NPI Number Information
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NPI Number | 1811549157
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Entity Type | Individual
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Provider Name | MARK NONSANT
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Gender | Male
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 6735 CONROY RD STE 303
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City | ORLANDO
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State | FL
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Zip | 32835-3569
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Country | US
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Telephone | 407-300-2830
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Fax |
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Provider Business Mailing Address
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Address Line | 441 S STATE ROAD 7 STE 15
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City | MARGATE
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State | FL
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Zip | 33068-1967
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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