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General NPI Number Information
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NPI Number | 1184672867
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Entity Type | Individual
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Provider Name | MARC H. FERRERA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 6501 ARLINGTON EXPY STE B105
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City | JACKSONVILLE
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State | FL
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Zip | 32211-0810
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Country | US
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Telephone | 757-752-0414
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Fax |
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Provider Business Mailing Address
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Address Line | 112 BARTRAM OAKS WALK
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City | ST JOHNS
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State | FL
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Zip | 32259-3266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME139058
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01061744A
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License Number State | IN
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