| Doctor Name: | PATRICIA MARVIN |
| NPI Number: | 1093897878 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-CMPH |
| License Number: | PA9102582 |
| Business Practice Address: | 899 N Summit St Crescent City, FL - 321122109 |
| Business Phone Number: | 3866981088 |
| Business Fax Number: | |
| Mailing Address: | 899 N Summit St, CRESCENT CITY |
| State: | FL |
| Postal Code: | 321122109 |
| Phone Number: | 3866981088 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9102582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |