Dr. Mark Edmund Pessa
Surgeon Trauma Surgeon
1350 S Hickory St Suite Pso
Melbourne
, Florida 32901
Dr. Mark Edmund Pessa
Surgeon Trauma Surgeon
1350 S Hickory St Suite Pso
Melbourne
, Florida 32901
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About
Features
Specialties
- Surgeon
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Mark Edmund Pessa
- 3300 S Fiske Blvd
- Rockledge, FL
- Zip : 32955-4306
- Phone :
Second Address
- Dr. Mark Edmund Pessa
- 1350 S Hickory St Suite Pso
- Melbourne, FL
- Zip : 32901
- Fax : (321) 434-1667
- Phone : (321) 434-1401
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | ME94760 | FL |
| N | 208600000X | Surgeon | ME94760 | FL |
| Y | 2086S0127X | Trauma Surgeon | ME94760 | FL |
National Provider Identifier
| NPI | 1174526958 |
|---|---|
| Provider Name | Dr. Mark Edmund Pessa |
| First Address | Rockledge, FL 32955-4306 |
| Second Address | Melbourne, FL 32901 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/05/2005 |
| Last Update Date | 04/04/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 274458900 | (05) | FL |
| 31607Y | MEDICARE (01) | FL |
| C20441 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.