Healthcare Provider Details

I. General information

NPI: 1164439717
Provider Name (Legal Business Name): ROBERT TRENT MAREMA M.D., F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD 5002
ST. AUGUSTINE FL
32086
US

IV. Provider business mailing address

PO BOX 3266
ST AUGUSTINE FL
32085-3266
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-5861
  • Fax: 904-819-5862
Mailing address:
  • Phone: 888-818-0563
  • Fax: 904-819-5862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME44766
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: