Healthcare Provider Details

I. General information

NPI: 1215532361
Provider Name (Legal Business Name): MARVOL ENTERPRISES LLC DBA MARVOL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 12/04/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10525 MOSS PARK RD
ORLANDO FL
32832
US

IV. Provider business mailing address

246 MESSINA PL
HOWEY IN THE HILLS FL
34737-3521
US

V. Phone/Fax

Practice location:
  • Phone: 352-324-6073
  • Fax:
Mailing address:
  • Phone: 352-324-6073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCELL SUTHERLAND
Title or Position: CEO
Credential:
Phone: 352-424-6073