MEDICARE: DR. MARSHALL BERNARD 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	207R00000X	Internal Medicine Physician	P26497	MD
2	207RC0000X	Cardiovascular Disease Physician	ME122508	FL
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME122508	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	:	1609160563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHALL BERNARD MARCUS M.D.

Provider Business Mailing Address
First Line	:	6006 49TH ST N STE 200
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2149
Country	:	US
Telephone Number	:	727-490-2100
Fax Number	:	855-222-3965

Provider Business Practice Location Address
First Line	:	6006 49TH ST N STE 200
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33709-2149
Country	:	US
Telephone Number	:	727-490-2100
Fax Number	:	855-222-3965

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

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	11/06/2019

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