MEDICARE: DR. GARDY D MARCELIN 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	207V00000X	Obstetrics & Gynecology Physician	ME76514	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

General Provider Information

NPI Number	:	1982606513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARDY D MARCELIN M.D.

Provider Business Mailing Address
First Line	:	3717 W BOYNTON BEACH BLVD STE 5
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4540
Country	:	US
Telephone Number	:	561-734-1212
Fax Number	:	561-734-1443

Provider Business Practice Location Address
First Line	:	3717 W BOYNTON BEACH BLVD STE 5
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4540
Country	:	US
Telephone Number	:	561-734-1212
Fax Number	:	561-734-1443

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	04/29/2021

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