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NPI Code Detail

MEDICARE: MARC A NATHANSON DPM

MEDICARE:   MARC A NATHANSON  DPM
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
1213ES0103XFoot & Ankle Surgery PodiatristPO2709FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14800029458OTHERFLRAILROAD MEDICARE
21304850001OTHERFLMEDICARE DME

General Provider Information

NPI Number : 1356307045
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC A NATHANSON DPM
Provider Business Mailing Address
First Line : 8851 BOARDROOM CIRCLE
Second Line :
City : FORT MEYERS
State : FL
Zip : 33919-4888
Country : US
Telephone Number : 239-481-7000
Fax Number : 239-481-8150
Provider Business Practice Location Address
First Line : 8851 BOARDROOM CIRCLE
Second Line :
City : FORT MEYERS
State : FL
Zip : 33919-4888
Country : US
Telephone Number : 239-481-7000
Fax Number : 239-481-8150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2006
Last Update Date : 03/13/2017

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Directions to “ MARC A NATHANSON DPM” Practice Location

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