Doctor Name: | BERTHA MARCELLINO |
NPI Number: | 1033144001 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | ME92093 |
Business Practice Address: | 3003 S Congress Ave Suite 1c Palm Springs, FL - 334612169 |
Business Phone Number: | 5614333460 |
Business Fax Number: | 5614333828 |
Mailing Address: | 2860 S Ocean Blvd Apt 509, PALM BEACH |
State: | FL |
Postal Code: | 334805562 |
Phone Number: | 5615865083 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 10/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | ME92093 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |