MEDICARE: DR. LAURIE LADAWN MARBAS 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	207Q00000X	Family Medicine Physician	DR.0048338	CO
2	207Q00000X	Family Medicine Physician	MD60805565	WA

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	:	1982672366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE LADAWN MARBAS M.D.

Provider Business Mailing Address
First Line	:	6303 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-6040
Country	:	US
Telephone Number	:	949-791-9745
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-6040
Country	:	US
Telephone Number	:	949-791-9745
Fax Number	:

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	04/26/2023

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