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General NPI Number Information
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NPI Number | 1336208685
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Entity Type | Organization
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Legal Business Name | ALEX J MARBAN MD PA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 290 W 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3763
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Country | US
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Telephone | 305-557-0642
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Fax | 305-557-1578
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Provider Business Mailing Address
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Address Line | 290 WEST 49TH STREET
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City | HIALEAH
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State | FL
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Zip | 33012-3763
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Country | US
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Telephone | 305-557-0642
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Fax | 305-557-1578
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CONNIE PADRON BESU
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Credential |
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Telephone | 305-557-0642
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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 | ME0072806
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License Number State | FL
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