Healthcare Provider Details

I. General information

NPI: 1003865262
Provider Name (Legal Business Name): MARCOS M CHERTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST SUITE 304
MIAMI FL
33125-1673
US

IV. Provider business mailing address

1321 NW 14TH ST SUITE 304
MIAMI FL
33125-1673
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-5481
  • Fax: 305-324-7852
Mailing address:
  • Phone: 305-324-5481
  • Fax: 305-324-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME0030210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: