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General NPI Number Information
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NPI Number | 1467471235
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Entity Type | Individual
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Provider Name | MARK JOHN MARZANO MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 1350 TAMIAMI TRL N STE 101
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City | NAPLES
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State | FL
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Zip | 34102-5209
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Country | US
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Telephone | 239-430-4674
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Fax | 239-659-6530
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Provider Business Mailing Address
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Address Line | 2338 IMMOKALEE RD SUITE 116
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City | NAPLES
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State | FL
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Zip | 34110-1445
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Country | US
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Telephone | 239-430-4674
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Fax | 239-430-0055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | ME81325
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME81325
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License Number State | FL
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