Mark Vincent Walter, M.D.

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

75251 Issued in FL

Practice address

2365 S Tamiami TRL
Sarasota, FL 34239-3808

Phone

(941) 955-4325

Fax

(941) 955-4395

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Healing Arts

  • Sports Medicine (Preventive Medicine) Physician
  • Sarasota, FL
  • NPI 1215156724
  NPD (past) Authorized official
• Premier Medical Services

  • Family Medicine Physician
  • Sarasota, FL
  • NPI 1790031748
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124247721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARADISE PLZ",
            "address_2": "SUITE 300",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396905",
            "telephone_number": "941-955-4325",
            "fax_number": "941-955-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 S TAMIAMI TRL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393808",
            "telephone_number": "941-955-4325",
            "fax_number": "941-955-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "MARK",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "FL",
            "license": "75251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David George Wallwork, LAT
• Emily A Walser
• Douglas A Walsh Sr., D.O.
• Ian M Walsh, DPT
• Jason Walsh, D.C.
• Amanda Kacey Walters, COTA
• Emily Cirelli Walters, PA
• Francesca Walters, DNP
• Janelle Rene Walters
• Kimberly D Walters, DC

• Sports Medicine (Preventive Medicine) Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Sports Medicine (Preventive Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.