Healthcare Provider Details

I. General information

NPI: 1184884090
Provider Name (Legal Business Name): MARIJO BILUSIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST STE 610B
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH STREET CRB SUITE 610B
MIAMI FL
33136-1007
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-9779
  • Fax:
Mailing address:
  • Phone: 305-243-1543
  • Fax: 305-243-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberMD447230
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA08421000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD447230
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME149070
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME149070
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: