Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | PO1182 | FL |
N | 213ES0000X | Sports Medicine | PO1182 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO1182 | FL |
N | 213ES0131X | Foot Surgery | PO1182 | FL |
NPI | 1225034176 |
---|---|
Provider Name | Dr. Mark Stewart Block |
First Address | Boca Raton, FL 33431-6466 |
Second Address | Boca Raton, FL 33431-6466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 20/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T95162 | (02) | FL |