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NPI Code Detail

MEDICARE: DR. MARCELLE G. HABIB MD.

MEDICARE: DR. MARCELLE G. HABIB MD.
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
1208000000XPediatrics Physician22519AZ
2208000000XPediatrics PhysicianME66844FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902887862
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCELLE G. HABIB MD.
Provider Business Mailing Address
First Line : 1020 LAKEVIEW RD
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-3423
Country : US
Telephone Number : 727-461-7730
Fax Number :
Provider Business Practice Location Address
First Line : 1020 LAKEVIEW RD
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-3423
Country : US
Telephone Number : 727-461-7730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 10/14/2021

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