MEDICARE: DR. MARTIN MARENUS DO

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	207Q00000X	Family Medicine Physician	OS4032	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	:	1114910866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN MARENUS DO

Provider Business Mailing Address
First Line	:	2057 N UNIVERSITY DR
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33322-3936
Country	:	US
Telephone Number	:	954-742-0330
Fax Number	:	954-742-8183

Provider Business Practice Location Address
First Line	:	2057 N UNIVERSITY DR
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33322-3936
Country	:	US
Telephone Number	:	954-742-0330
Fax Number	:	954-742-8183

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

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	12/18/2012

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Directions to “ DR. MARTIN MARENUS DO” Practice Location

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