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General NPI Number Information
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NPI Number | 1033474911
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Entity Type | Organization
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Legal Business Name | MARATHON VERTERINARY HOSPITAL INC.
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Dates
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Enumeration Date | 07/07/2012
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Last Update Date | 07/07/2012
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Provider Practice Location Address
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Address Line | 11187 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-3460
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Country | US
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Telephone | 305-743-7099
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Fax | 305-743-4057
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Provider Business Mailing Address
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Address Line | 11187 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-3460
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Country | US
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Telephone | 305-743-7099
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Fax | 305-743-4057
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | DR. GERALDINE DIETHELM-MADER
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Credential |
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Telephone | 305-743-7099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | VM 7228
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License Number State | FL
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