Provider Demographics
NPI:1386050854
Name:REJUVEFACE, LLC
Entity type:Organization
Organization Name:REJUVEFACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACIAL PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHECCONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-735-7532
Mailing Address - Street 1:4901 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3251
Mailing Address - Country:US
Mailing Address - Phone:941-404-5438
Mailing Address - Fax:941-953-4600
Practice Address - Street 1:4901 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3251
Practice Address - Country:US
Practice Address - Phone:941-735-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-06
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty