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General NPI Number Information
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NPI Number | 1265876692
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Entity Type | Organization
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Legal Business Name | MARVIN MORDES, M.D., P.A.
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 4920 LORING DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-8052
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Country | US
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Telephone | 561-209-1086
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Fax | 561-209-6355
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Provider Business Mailing Address
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Address Line | 4920 LORING DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-8052
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Country | US
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Telephone | 561-209-1086
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Fax | 561-209-6355
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Authorized Official
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Title or Position | CEO
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Name | DR. MARVIN MORDES
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Credential | M.D.
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Telephone | 561-209-1086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME87570
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License Number State | FL
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