Healthcare Provider Details
I. General information
NPI: 1154390508
Provider Name (Legal Business Name): MARC S LAMPELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/17/2006
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4560 LANTANA RD STE 110115
LAKE WORTH FL
33463-6998
US
IV. Provider business mailing address
28744 MONTECRISTO LOOP
BONITA SPRINGS FL
34135-8942
US
V. Phone/Fax
- Phone: 305-266-2929
- Fax:
- Phone: 516-455-7181
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | ME130939 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: