MEDICARE: ROBERT D MARKS M.S.

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	171M00000X	Case Manager/Care Coordinator

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	:	1538678693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT D MARKS M.S.

Provider Business Mailing Address
First Line	:	127 MARTIN ST
Second Line	:
City	:	INDIAN HARBOUR BEACH
State	:	FL
Zip	:	32937-2728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3155 LAKE WORTH RD
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-6917
Country	:	US
Telephone Number	:	561-439-8440
Fax Number	:

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

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	09/21/2017

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