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General NPI Number Information
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NPI Number | 1134240526
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Entity Type | Organization
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Legal Business Name | MARTIN L MARENUS D.O. P.A
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 2057 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322
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Country | US
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Telephone | 954-742-0330
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Fax | 954-742-8183
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Provider Business Mailing Address
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Address Line | 2057 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322
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Country | US
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Telephone | 954-742-0330
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Fax | 954-742-8183
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. MARTIN L MARENUS
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Credential | D.O.
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Telephone | 954-742-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0004032
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License Number State | FL
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