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General NPI Number Information
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NPI Number | 1548500812
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Entity Type | Organization
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Legal Business Name | MARHOLIN MEDICAL INSTITUTE LLC
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Dates
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Enumeration Date | 02/25/2013
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 17307 PAGONIA DR SUITE 100
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City | CLERMONT
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State | FL
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Zip | 34711-5932
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Country | US
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Telephone | 352-989-5901
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Fax |
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Provider Business Mailing Address
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Address Line | 4327 S HIGHWAY 27
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City | CLERMONT
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State | FL
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Zip | 34711-5349
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Country | US
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Telephone | 352-989-5901
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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. MAURICE D MARHOLIN
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Credential | D.O.
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Telephone | 352-989-5901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 7330
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License Number State | FL
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