Healthcare Provider Details

I. General information

NPI: 1295865293
Provider Name (Legal Business Name): MARCOS SZOMSTEIN MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7765 SW 87TH AVE SUITE 212A
MIAMI FL
33173-2596
US

IV. Provider business mailing address

PO BOX 144221
CORAL GABLES FL
33114-4221
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-3080
  • Fax: 305-596-3073
Mailing address:
  • Phone: 305-596-3080
  • Fax: 305-596-3073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCOS SZOMSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 305-596-3080