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General NPI Number Information
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NPI Number | 1336160514
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Entity Type | Organization
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Legal Business Name | MARIANA MARTINASEVIC MD PA
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 6245 N FEDERAL HWY SUITE 201
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-1998
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Country | US
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Telephone | 954-491-4455
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Fax | 954-491-4553
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Provider Business Mailing Address
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Address Line | 6245 N FEDERAL HWY SUITE 201
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-1998
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Country | US
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Telephone | 954-491-4455
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Fax | 954-491-4553
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Authorized Official
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Title or Position | CEO
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Name | MRS. MARIANA MARTINASEVIC
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Credential | M D
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Telephone | 954-491-4455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME87810
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License Number State | FL
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