Healthcare Provider Details

I. General information

NPI: 1487587440
Provider Name (Legal Business Name): MARBLE HEALTH MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 E WETMORE RD STE 370
TUCSON AZ
85705-1773
US

IV. Provider business mailing address

521 BROADWAY FL 4
NEW YORK NY
10012-4454
US

V. Phone/Fax

Practice location:
  • Phone: 332-232-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL ROSS
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 332-232-0200