Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME113636 | FL |
N | 207YS0123X | Facial Plastic Surgeon | ME113636 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | ME113636 | FL |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME113636 | FL |
NPI | 1548463839 |
---|---|
Provider Name | Dr. Mark A Checcone |
First Address | Sarasota, FL 34239-2217 |
Second Address | Sarasota, FL 34239-2217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 26/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GM985X | (02) | FL |
GM985Y | (02) | FL |