MEDICARE: M JEFFREY MARCUS MD FACS PA

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	ME20810	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DG0919	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44142	OTHER	FL	BLUE CROSS
3	59200023722	OTHER	FL	TAX ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053460220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M JEFFREY MARCUS MD FACS PA

Provider Business Mailing Address
First Line	:	821 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-726-3131
Fax Number	:	352-726-7202

Provider Business Practice Location Address
First Line	:	821 MEDICAL CT E
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4623
Country	:	US
Telephone Number	:	352-726-3131
Fax Number	:	888-491-4367

Authorized Official
Title or Position	:	MEDICAL PHYSICIAN
Name	:	M JEFFREY MARCUS
Credential	:
Telephone Number	:	352-726-3131

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	06/29/2021

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