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General NPI Number Information
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NPI Number | 1659535987
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Entity Type | Individual
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Provider Name | INDIRA M MARMOLEJOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 6238 W ATLANTIC AVE SUITE 2
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City | DELRAY BEACH
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State | FL
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Zip | 33484-3501
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Country | US
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Telephone | 561-404-9845
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Fax | 561-404-9849
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Provider Business Mailing Address
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Address Line | 2605 W ATLANTIC AVE STE D101
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4414
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Country | US
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Telephone | 561-404-9845
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Fax | 561-404-9849
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME99093
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License Number State | FL
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