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NPI Code Detail

MEDICARE: DR. THOMAS JOHN MARCIC PH.D.

MEDICARE:  DR. THOMAS JOHN MARCIC  PH.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
1103TC0700XClinical PsychologistPY003378FL

General Provider Information

NPI Number : 1689761447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JOHN MARCIC PH.D.
Provider Business Mailing Address
First Line : 17337 KENNEDY DR
Second Line :
City : NORTH REDINGTON BEACH
State : FL
Zip : 33708-1350
Country : US
Telephone Number : 727-409-4045
Fax Number : 352-596-4581
Provider Business Practice Location Address
First Line : 17337 KENNEDY DR
Second Line :
City : NORTH REDINGTON BEACH
State : FL
Zip : 33708-1350
Country : US
Telephone Number : 727-409-4045
Fax Number : 352-596-4581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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Directions to “ DR. THOMAS JOHN MARCIC PH.D.” Practice Location

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