Provider Demographics
NPI:1194831479
Name:NORSTEIN, MARK B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:NORSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10051 5TH STREET NORTH #200
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-5620
Mailing Address - Country:US
Mailing Address - Phone:727-824-0780
Mailing Address - Fax:727-568-6011
Practice Address - Street 1:1100 62ND AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-5620
Practice Address - Country:US
Practice Address - Phone:727-866-3166
Practice Address - Fax:727-864-4043
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0034232207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10618501OtherCITRUS
FL080128686OtherRAILROAD MEDICARE
FL62202WOtherBLUE CROSS/BLUE SHIELD
FL204937OtherAVMED
FL672595012OtherCIGNA
FL1013896OtherAETNA
FL38395300Medicaid
FL039395300Medicaid
FL225530OtherWELLCARE
FL672595012OtherCIGNA
FL080128686OtherRAILROAD MEDICARE
FL039395300Medicaid