Healthcare Provider Details

I. General information

NPI: 1639431679
Provider Name (Legal Business Name): MARC PINN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD SUITE 100
BOCA RATON FL
33487-2768
US

IV. Provider business mailing address

1601 CLINT MOORE RD STE 100
BOCA RATON FL
33487-5712
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-2147
  • Fax:
Mailing address:
  • Phone: 561-939-0200
  • Fax: 561-939-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberOS13699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: