MEDICARE: DR. MARCUS ST JOHN 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	207RI0011X	Interventional Cardiology Physician	ME90609	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073510269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCUS ST JOHN MD

Provider Business Mailing Address
First Line	:	8950 N KENDALL DR
Second Line	:	STE 501
City	:	MIAMI
State	:	FL
Zip	:	33176-2132
Country	:	US
Telephone Number	:	305-412-3558
Fax Number	:	305-412-3515

Provider Business Practice Location Address
First Line	:	8950 N KENDALL DR
Second Line	:	STE 501
City	:	MIAMI
State	:	FL
Zip	:	33176-2132
Country	:	US
Telephone Number	:	305-412-3558
Fax Number	:	305-412-3515

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	01/30/2022

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Directions to “ DR. MARCUS ST JOHN MD” Practice Location

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