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General NPI Number Information
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NPI Number | 1225452618
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Entity Type | Organization
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Legal Business Name | VANESSA C. MARINO, O.D., P.A.
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 8353 SW 124TH ST STE 106
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City | MIAMI
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State | FL
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Zip | 33156-5847
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Country | US
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Telephone | 305-233-2040
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Fax | 305-233-2052
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Provider Business Mailing Address
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Address Line | 8353 SW 124TH ST STE 106
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City | MIAMI
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State | FL
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Zip | 33156-5847
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Country | US
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Telephone | 305-233-2040
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Fax | 305-233-2052
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Authorized Official
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Title or Position | OPOMETRIST
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Name | DR. VANESSA CARIDAD MARINO
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Credential | O.D.
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Telephone | 305-233-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC4223
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License Number State | FL
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