| Doctor Name: | MARINA PERMIAKOVA |
| NPI Number: | 1164763215 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | BP10042480 |
| Business Practice Address: | 14416 W Meeker Blvd Bldg C Ste 200 Sun City West, AZ - 853755284 |
| Business Phone Number: | 6235835271 |
| Business Fax Number: | |
| Mailing Address: | 14416 W Meeker Blvd Bldg C, Ste 200 SUN CITY WEST |
| State: | AZ |
| Postal Code: | 853755284 |
| Phone Number: | 6235835271 |
| Fax Number: | |
| NPI Enumeration Date: | 03/13/2013 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | BP10042480 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |