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General NPI Number Information
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NPI Number | 1669622130
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Entity Type | Organization
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Legal Business Name | ANGEL B MARIN MD PA
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 6195 W 8TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-6537
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Country | US
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Telephone | 305-822-3019
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Fax | 305-822-3048
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Provider Business Mailing Address
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Address Line | PO BOX 22635
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City | HIALEAH
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State | FL
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Zip | 33002-2634
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Country | US
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Telephone | 305-822-3019
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Fax | 305-822-3048
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGEL B MARIN
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Credential | MD PA
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Telephone | 305-822-3019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME21831
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License Number State | FL
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