MEDICARE: TROY MARCEL FINLEY

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	DN27459	FL
2	1223G0001X	General Practice Dentistry	DN27459	FL

General Provider Information

NPI Number	:	1861123093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY MARCEL FINLEY

Provider Business Mailing Address
First Line	:	4971 SW 163RD AVE
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4952
Country	:	US
Telephone Number	:	954-701-3995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 DUNLAWTON AVE
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-2925
Country	:	US
Telephone Number	:	386-233-3040
Fax Number	:

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

Provider Enumeration Date	:	06/20/2022
Last Update Date	:	08/16/2022

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Directions to “ TROY MARCEL FINLEY ” Practice Location

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