MEDICARE: DAVID ASHLEY MARCANTEL M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME68062	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	:	1275530628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ASHLEY MARCANTEL M.D.

Provider Business Mailing Address
First Line	:	410 CELEBRATION PL
Second Line	:	SUITE 208
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5433
Country	:	US
Telephone Number	:	407-566-2229
Fax Number	:	407-566-2499

Provider Business Practice Location Address
First Line	:	410 CELEBRATION PL
Second Line	:	SUITE 208
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5433
Country	:	US
Telephone Number	:	407-566-2229
Fax Number	:	407-566-2499

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/25/2024

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