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NPI Code Detail

MEDICARE: DR. JOHN M MARCIN OD

MEDICARE: DR. JOHN M MARCIN OD
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
1152W00000XOptometristOPC832FL

Other Identifiers

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

General Provider Information

NPI Number : 1336131002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN M MARCIN OD
Provider Business Mailing Address
First Line : 2003 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34207-1241
Country : US
Telephone Number : 941-756-2020
Fax Number : 941-756-4486
Provider Business Practice Location Address
First Line : 2003 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34207-1241
Country : US
Telephone Number : 941-756-2020
Fax Number : 941-756-4486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 06/16/2010

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