MEDICARE: MARSHALL HEALTH, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	111NR0400X	Rehabilitation Chiropractor
2	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician
3	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1396260964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSHALL HEALTH, INC.

Provider Business Mailing Address
First Line	:	1380 NE MIAMI GARDENS DR STE 264
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-4721
Country	:	US
Telephone Number	:	305-587-5599
Fax Number	:	305-675-5797

Provider Business Practice Location Address
First Line	:	1380 NE MIAMI GARDENS DR STE 264
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-4721
Country	:	US
Telephone Number	:	305-587-5599
Fax Number	:	305-675-5797

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GUSTAVO H MARSHALL JR.
Credential	:	DC
Telephone Number	:	305-587-5599

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	06/18/2022

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Directions to “MARSHALL HEALTH, INC. ” Practice Location

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