MEDICARE: MR. MARC NAZON JR. LMFT

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	171M00000X	Case Manager/Care Coordinator
2	106H00000X	Marriage & Family Therapist	MT4638	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	:	1871772046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARC NAZON JR. LMFT

Provider Business Mailing Address
First Line	:	PO BOX 160566
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33116-0566
Country	:	US
Telephone Number	:	786-546-0917
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 W BROWARD BLVD STE 100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1018
Country	:	US
Telephone Number	:	786-520-5646
Fax Number	:

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

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	04/18/2024

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