Provider Demographics
NPI:1285029512
Name:MARK C DROFFNER
Entity Type:Organization
Organization Name:MARK C DROFFNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:DROFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-637-0911
Mailing Address - Street 1:260 MILUS ST
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3824
Mailing Address - Country:US
Mailing Address - Phone:941-637-0911
Mailing Address - Fax:941-637-9153
Practice Address - Street 1:260 MILUS ST
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3824
Practice Address - Country:US
Practice Address - Phone:941-637-0911
Practice Address - Fax:941-637-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty