MEDICARE: GINA MARCUS DMD

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	1223G0001X	General Practice Dentistry	DN 16388	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1598841496	OTHER	FL	DENTAL

General Provider Information

NPI Number	:	1952312415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA MARCUS DMD

Provider Business Mailing Address
First Line	:	2600 S DOUGLAS RD STE 906
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6142
Country	:	US
Telephone Number	:	305-998-2970
Fax Number	:	305-374-5551

Provider Business Practice Location Address
First Line	:	2600 S DOUGLAS RD STE 906
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6142
Country	:	US
Telephone Number	:	305-998-2970
Fax Number	:	305-374-5551

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	09/11/2023

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Directions to “ GINA MARCUS DMD” Practice Location

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