=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265737134
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARVIN I SCHIFF M.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2011
-----------------------------------------------------
Last Update Date | 01/24/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27 NE 1ST AVE
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33060-6609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-942-1291
-----------------------------------------------------
Fax | 954-786-2055
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 NE 1ST AVE
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33060-6609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-942-1291
-----------------------------------------------------
Fax | 954-786-2055
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. MARVIN I SCHIFF
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 954-942-1291
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | 038797
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------