Mark E Petrites, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME73280 Issued in FL

Practice address

3501 Health Center Blvd
Ste 2110
Bonita Springs, FL 34135-8127

Phone

(239) 495-3990

Fax

(239) 949-2888

NPI assigned

Sep 20, 2007

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1962698142",
    "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": "341367446",
            "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": "341358127",
            "telephone_number": "239-495-3990",
            "fax_number": "239-949-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRITES",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME73280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Tasha Perez, LMT, DOM, AP
• Nelly Marie Perez, M.D.
• Performance Optimal Health Bonita Springs, LLC
• Person Dental PLLC
• Felicia Peters, MS CCC SLP
• Gregory Asher Pette, D.M.D., M.S.
• William A. Pettinger, M.D.
• Jacqueline Pettit, DPT
• Todd A Pezzi, MD
• PHC Management Services, LLC

• 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 20, 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.