Healthcare Provider Details

I. General information

NPI: 1821498585
Provider Name (Legal Business Name): JOHN P. MARION, D.P.M., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2014
Last Update Date: 09/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W 16TH AVE 53
HIALEAH FL
33012-7100
US

IV. Provider business mailing address

4410 W 16TH AVE 53
HIALEAH FL
33012-7100
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-7437
  • Fax:
Mailing address:
  • Phone: 305-558-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3635
License Number StateFL

VIII. Authorized Official

Name: JOHN PATRICK MARION
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 305-776-1055