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

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, MD

Title

Owner

Phone

(239) 495-3990

Specialties & licenses 1

Addresses

Locations

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.