=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235830134
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARRS EAR, NOSE & THROAT, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2023
-----------------------------------------------------
Last Update Date | 04/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5310 CLARK RD STE 102
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-3228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-231-1031
-----------------------------------------------------
Fax | 941-761-6248
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5310 CLARK RD STE 102
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-3228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-231-1031
-----------------------------------------------------
Fax | 941-761-6248
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHAD MARRS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 941-231-1031
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------