Healthcare Provider Details

I. General information

NPI: 1043430697
Provider Name (Legal Business Name): MARVIN J MERRIT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 06/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 SW 26TH AVE
POMPANO BEACH FL
33069-4315
US

IV. Provider business mailing address

1000 E ATLANTIC BLVD STE 111
POMPANO BEACH FL
33060-7447
US

V. Phone/Fax

Practice location:
  • Phone: 954-968-4144
  • Fax:
Mailing address:
  • Phone: 954-968-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0004983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: