Healthcare Provider Details

I. General information

NPI: 1497708457
Provider Name (Legal Business Name): MARINERS EMERGENCY PHYSICIANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91500 OVERSEAS HWY
TAVERNIER FL
33070-2547
US

IV. Provider business mailing address

8660 W FLAGLER ST SUITE 200
MIAMI FL
33144-2036
US

V. Phone/Fax

Practice location:
  • Phone: 305-853-1600
  • Fax: 305-554-4858
Mailing address:
  • Phone: 305-227-5176
  • Fax: 305-554-4858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID R NATEMAN
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 786-596-7992