Healthcare Provider Details

I. General information

NPI: 1972514073
Provider Name (Legal Business Name): MARIANA R LOOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4670 FOREST HILL BLVD
WEST PALM BEACH FL
33415-5640
US

IV. Provider business mailing address

4670 FOREST HILL BLVD
WEST PALM BEACH FL
33415-5640
US

V. Phone/Fax

Practice location:
  • Phone: 561-247-7614
  • Fax: 561-247-7819
Mailing address:
  • Phone: 561-247-7614
  • Fax: 561-246-7614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME54202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: