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General NPI Number Information
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NPI Number | 1982846648
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Entity Type | Organization
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Legal Business Name | MARK A. GENDAL, O.D., P.A.
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2059 UNIVERSITY DRIVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33071
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Country | US
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Telephone | 954-752-0589
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Fax | 954-753-1101
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Provider Business Mailing Address
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Address Line | 2059 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6132
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Country | US
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Telephone | 954-752-0589
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Fax | 954-753-1101
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ANDREW GENDAL
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Credential |
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Telephone | 954-753-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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