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General NPI Number Information
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NPI Number | 1912835828
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Entity Type | Individual
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Provider Name | MARK A BERTEMATTI MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 1501 N CAMPELL AVE ROOM 5304D
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City | TUCSON
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State | AZ
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Zip | 85724-5058
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Country | US
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Telephone | 520-626-9540
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Fax |
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Provider Business Mailing Address
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Address Line | 8191 SW 143RD ST
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City | PALMETTO BAY
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State | FL
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Zip | 33158-1568
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Country | US
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Telephone | 305-794-7888
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R82456
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License Number State | AZ
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