Mark E Petrites MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME73280 Issued in FL

Legal business name

MARK E PETRITES MD PA

Practice address

3501 Health Center Blvd
Ste 2110
Bonita Springs, FL 34135

Phone

(239) 495-3990

Fax

(239) 949-2888

NPI assigned

Aug 24, 2006

Last updated

Sep 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark E Petrites, MDNPI 1962698142

Title

Owner

Phone

(239) 495-3990

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark E Petrites, MD

  • Surgery Physician
  • Bonita Springs, FL
  • NPI 1962698142
  Authorized official Same address or phone

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1831206002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367446",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34136",
            "telephone_number": "239-495-3990",
            "fax_number": "239-949-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD",
            "address_2": "STE 2110",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34135",
            "telephone_number": "239-495-3990",
            "fax_number": "239-949-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E PETRITES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "PETRITES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-495-3990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME73280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.