Healthcare Provider Details

I. General information

NPI: 1174466056
Provider Name (Legal Business Name): MARIA M MARCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 SW 186TH WAY
SW RANCHES FL
33332-1464
US

IV. Provider business mailing address

6300 SW 186TH WAY
SW RANCHES FL
33332-1464
US

V. Phone/Fax

Practice location:
  • Phone: 954-955-6652
  • Fax:
Mailing address:
  • Phone: 954-955-6652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: