Provider Demographics
NPI:1740341726
Name:SOCINSKI, MARK A (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:SOCINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2501 N ORANGE AVE STE 689
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4648
Mailing Address - Country:US
Mailing Address - Phone:407-303-2024
Mailing Address - Fax:407-303-2038
Practice Address - Street 1:2501 N ORANGE AVE STE 689
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4648
Practice Address - Country:US
Practice Address - Phone:407-303-2024
Practice Address - Fax:407-303-2038
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2016-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC009500454207RH0003X
FLME128890207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8978409Medicaid
NC8978409Medicaid
NCA58526Medicare UPIN