Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME127648 | FL |
N | 208600000X | Surgeon | ME127648 | FL |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME127648 | FL |
NPI | 1124263603 |
---|---|
Provider Name | Dr. Mark Joseph Meyer |
First Address | West Palm Beach, FL 33406-7614 |
Second Address | Lake Worth, FL 33462-1159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2008 |
Last Update Date | 23/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017961100 | (05) | FL |