Healthcare Provider Details

I. General information

NPI: 1295946598
Provider Name (Legal Business Name): RIAN MAERCKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 BISCAYNE BLVD STE 104
MIAMI FL
33137-3227
US

IV. Provider business mailing address

4500 BISCAYNE BLVD STE 104
MIAMI FL
33137-3227
US

V. Phone/Fax

Practice location:
  • Phone: 305-328-8256
  • Fax: 305-468-4592
Mailing address:
  • Phone: 305-328-8256
  • Fax: 305-468-4592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberME103392
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: