MEDICARE: MARBIS AVITIA DMD

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	1223G0001X	General Practice Dentistry	DN30387	FL

General Provider Information

NPI Number	:	1649161282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARBIS AVITIA DMD

Provider Business Mailing Address
First Line	:	9093 NUGENT TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-6325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11151 SOUTHERN BLVD STE 110
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-4260
Country	:	US
Telephone Number	:	561-246-6371
Fax Number	:

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

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	07/16/2025

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Directions to “ MARBIS AVITIA DMD” Practice Location

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