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1023647419
MARK DERASMO
SAN ANTONIO, TX
NPI
1023647419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MS 30410)
Enumeration Date
2020-04-07
Last Update Date
2023-08-22
Business Address
MARK DERASMO MD
3551 ROGER BROOKE DR
SAN ANTONIO, TX 78234-4504
Phone number: 210-916-4141
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Mailing Address
MARK DERASMO MD
2068 GROVELAND RD
PALM HARBOR, FL 34683-3332
Phone number: 727-483-2551
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