Healthcare Provider Details

I. General information

NPI: 1801027156
Provider Name (Legal Business Name): CLAUDIA MARCELO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E MCNAB RD STE B
POMPANO BEACH FL
33060-9240
US

IV. Provider business mailing address

1761 NE 42ND ST
OAKLAND PARK FL
33334-5463
US

V. Phone/Fax

Practice location:
  • Phone: 786-422-1776
  • Fax: 954-417-6105
Mailing address:
  • Phone: 954-342-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS10719
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS10719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: