Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME132324 | FL |
Y | 208600000X | Surgeon | ME132324 | FL |
N | 2086S0102X | Surgical Critical Care | ME132324 | FL |
N | 2086S0127X | Trauma Surgeon | ME132324 | FL |
NPI | 1104040252 |
---|---|
Provider Name | Dr. Mark David Buzzelli |
First Address | Miami, FL 33136-1018 |
Second Address | Miami, FL 33136-1018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 17/03/2018 |