MEDICARE: DR. M JEFFREY MARCUS 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	207YX0602X	Otolaryngic Allergy Physician	ME20810	FL
2	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	ME20810	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44142	OTHER	FL	BLUE CROSS
2	592023722	OTHER	FL	TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427057397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. M JEFFREY MARCUS M.D.

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	:	888-491-4367

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	06/29/2021

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