MEDICARE: DR. MARLON OSBOURNE M.D.

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	207ZF0201X	Forensic Pathology Physician	ME121731	FL
2	207ZP0101X	Anatomic Pathology Physician	ME121731	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295092583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLON OSBOURNE M.D.

Provider Business Mailing Address
First Line	:	3561 SW 10TH ST
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4827
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3561 SW 10TH ST
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4827
Country	:	US
Telephone Number	:	954-977-7959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	01/17/2024

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