MEDICARE: RONALD M MARINI DMD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN8441	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	991268	OTHER	FL	COMDENT HEALTHY KIDS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285773465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD M MARINI DMD PA

Provider Business Mailing Address
First Line	:	1495 STELLAR DR
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9685
Country	:	US
Telephone Number	:	407-365-3817
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 S ORLANDO DR
Second Line	:	SUITE 146
City	:	SANFORD
State	:	FL
Zip	:	32773-4103
Country	:	US
Telephone Number	:	407-322-9992
Fax Number	:	407-322-4415

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD MICHAEL MARINI
Credential	:	D.M.D.
Telephone Number	:	407-322-9992

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	12/13/2011

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Directions to “RONALD M MARINI DMD PA ” Practice Location

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