MEDICARE: DR. MARCOS AGUSTIN NORES 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME108415	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	CJ6802	OTHER	KY	PALMETTO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598767543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCOS AGUSTIN NORES M.D.

Provider Business Mailing Address
First Line	:	5301 SOUTH CONGRESS AVE. SUITE 300
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-548-4900
Fax Number	:	561-548-4902

Provider Business Practice Location Address
First Line	:	5301 S CONGRESS AVE
Second Line	:	SUITE 300
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1149
Country	:	US
Telephone Number	:	561-548-4900
Fax Number	:	561-548-4900

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/26/2013

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