Provider Demographics
NPI:1861491276
Name:DRESNER, MARK STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:DRESNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 SPYGLASS HILL ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7984
Mailing Address - Country:US
Mailing Address - Phone:321-253-1919
Mailing Address - Fax:
Practice Address - Street 1:8045 SPYGLASS HILL ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-7984
Practice Address - Country:US
Practice Address - Phone:321-253-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55925207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE38037Medicare UPIN