Healthcare Provider Details

I. General information

NPI: 1386612869
Provider Name (Legal Business Name): JAIME MARCHAND MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 S STATE ROAD 7 STE 109
WELLINGTON FL
33449-8099
US

IV. Provider business mailing address

3319 S STATE ROAD 7 STE 109
WELLINGTON FL
33449-8099
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-5437
  • Fax: 305-662-3723
Mailing address:
  • Phone: 561-798-5437
  • Fax: 305-662-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0068890
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME68890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: