MEDICARE: DR. MARINA NUDEL D.D.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	122300000X	Dentist	DN 19619	FL

General Provider Information

NPI Number	:	1821088741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARINA NUDEL D.D.S

Provider Business Mailing Address
First Line	:	1800 S OCEAN DR
Second Line	:	UNIT 3303
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-7734
Country	:	US
Telephone Number	:	954-234-8600
Fax Number	:	954-234-8600

Provider Business Practice Location Address
First Line	:	1800 S OCEAN DR
Second Line	:	UNIT 3303
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-7734
Country	:	US
Telephone Number	:	954-234-8600
Fax Number	:	954-234-8600

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	04/05/2015

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