MEDICARE: DR. JAMMAL ALEXANDER MARCANO BURET MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME171480	FL

General Provider Information

NPI Number	:	1023740404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMMAL ALEXANDER MARCANO BURET MD

Provider Business Mailing Address
First Line	:	PO BOX 947407
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30394-7407
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	2345 BOBCAT VILLAGE CENTER RD UNIT 202
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-8999
Country	:	US
Telephone Number	:	941-257-2930
Fax Number	:	941-257-2923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2022
Last Update Date	:	07/18/2025

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