Provider Demographics
NPI:1598926412
Name:ON THE MARK INC
Entity Type:Organization
Organization Name:ON THE MARK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:DOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-876-8037
Mailing Address - Street 1:258 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4557
Mailing Address - Country:US
Mailing Address - Phone:954-876-8037
Mailing Address - Fax:954-973-1668
Practice Address - Street 1:258 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4557
Practice Address - Country:US
Practice Address - Phone:954-876-8037
Practice Address - Fax:954-973-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1202261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078944500Medicaid
FL19823AMedicare PIN
FL078944500Medicaid