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General NPI Number Information
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NPI Number | 1396043048
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Entity Type | Organization
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Legal Business Name | MARCIO C. FEREZ, M.D.P.A.
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 777 E 25TH ST SUITE 206
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City | HIALEAH
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State | FL
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Zip | 33013-3825
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Country | US
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Telephone | 305-835-4648
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Fax |
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Provider Business Mailing Address
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Address Line | 777 E 25TH ST SUITE 206
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City | HIALEAH
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State | FL
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Zip | 33013-3825
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Country | US
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Telephone | 305-835-4648
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARCIO C FEREZ
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Credential | M.D.
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Telephone | 305-496-9667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME34354
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License Number State | FL
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