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NPI Code Detail

MEDICARE: MARCELLA SCACCIA MD

MEDICARE:   MARCELLA  SCACCIA  MD
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
1207QG0300XGeriatric Medicine (Family Medicine) Physician241739NY
2207QG0300XGeriatric Medicine (Family Medicine) Physician109319FL
3207QH0002XHospice and Palliative Medicine (Family Medicine) Physician109319FL

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 : 1669689311
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCELLA SCACCIA MD
Provider Business Mailing Address
First Line : 2937 S ATLANTIC AVE APT 602
Second Line :
City : DAYTONA BEACH SHORES
State : FL
Zip : 32118-6045
Country : US
Telephone Number : 386-871-4515
Fax Number :
Provider Business Practice Location Address
First Line : 2937 S ATLANTIC AVE APT 602
Second Line :
City : DAYTONA BEACH SHORES
State : FL
Zip : 32118-6045
Country : US
Telephone Number : 386-871-4515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/10/2023

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Directions to “ MARCELLA SCACCIA MD” Practice Location

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