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NPI Code Detail

MEDICARE: MARIANNA DORTA

MEDICARE: MARIANNA DORTA
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
1207V00000XObstetrics & Gynecology PhysicianTRN35391FL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1639828031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNA DORTA
Provider Business Mailing Address
First Line : 1611 NW 12TH AVE STE 4070
Second Line :
City : MIAMI
State : FL
Zip : 33136-1005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1611 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33136-1005
Country : US
Telephone Number : 305-585-3771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 06/02/2026

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Directions to “ MARIANNA DORTA ” Practice Location

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