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NPI Code Detail

MEDICARE: DR. MARZA SMITH PENNY M.D.

MEDICARE:  DR. MARZA SMITH PENNY  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
1208000000XPediatrics PhysicianME0074526FL

Other Identifiers

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

General Provider Information

NPI Number : 1518029214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARZA SMITH PENNY M.D.
Provider Business Mailing Address
First Line : 8005 BAY ST
Second Line : SUITE 4
City : SEBASTIAN
State : FL
Zip : 32958-3244
Country : US
Telephone Number : 772-581-0300
Fax Number : 772-581-0010
Provider Business Practice Location Address
First Line : 8005 BAY ST
Second Line : SUITE 4
City : SEBASTIAN
State : FL
Zip : 32958-3244
Country : US
Telephone Number : 772-581-0300
Fax Number : 772-581-0010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2006
Last Update Date : 04/15/2014

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Directions to “ DR. MARZA SMITH PENNY M.D.” Practice Location

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