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General NPI Number Information
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NPI Number | 1831551670
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Entity Type | Organization
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Legal Business Name | MARIMON PEDIATRICS LLC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 3661 S MIAMI AVE STE 803
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City | MIAMI
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State | FL
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Zip | 33133-4214
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Country | US
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Telephone | 786-600-4733
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Fax | 786-724-4889
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Provider Business Mailing Address
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Address Line | 3661 S MIAMI AVE STE 803
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City | MIAMI
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State | FL
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Zip | 33133-4214
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Country | US
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Telephone | 786-600-4733
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Fax | 786-724-4889
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | GILMA A MARIMON
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Credential | MD
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Telephone | 786-600-4733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME115028
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License Number State | FL
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