Mark A. Daicoff, PA-C
Physician Assistant, Surgical in St Petersburg, FL. Individual provider (NPI-1).
NPI number1184282907
StatusActive
Last updated in NPPESJan 14, 2025
Details
- NPI
- 1184282907
- Entity type
- Individual (NPI-1)
- Name
- Mark A. Daicoff
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2019
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | PA9112118 | FL | Yes |
Practice location
601 7th St S Ste 205St Petersburg, FL 33701-4748
Phone 727-893-6235 · Fax 727-553-7422
Mailing address
601 7th St S Ste 205St Petersburg, FL 33701-4748
Phone 727-893-6235 · Fax 727-553-7422
Other practice locations
4600 4th St N
St Petersburg, FL 33703-3802
St Petersburg, FL 33703-3802
Phone 727-527-5272
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