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General NPI Number Information
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NPI Number | 1093901241
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Entity Type | Organization
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Legal Business Name | CONSTANTINE G. MAROUSIS MD PA
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 1950 ARLINGTON ST SUITE 101
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City | SARASOTA
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State | FL
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Zip | 34239-3507
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Country | US
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Telephone | 941-366-1400
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Fax | 941-366-1913
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Provider Business Mailing Address
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Address Line | 1950 ARLINGTON ST SUITE 101
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City | SARASOTA
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State | FL
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Zip | 34239-3507
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Country | US
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Telephone | 941-366-1400
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Fax | 941-366-1913
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Authorized Official
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Title or Position | OWNER
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Name | DR. CONSTANTINE GREGORY MAROUSIS
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Credential | MD
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Telephone | 941-366-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME73113
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License Number State | FL
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