Provider Demographics
NPI:1013199595
Name:MARWAN ISKANDARANI MD PA
Entity Type:Organization
Organization Name:MARWAN ISKANDARANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKANDARANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-653-6365
Mailing Address - Street 1:65 NW 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6027
Mailing Address - Country:US
Mailing Address - Phone:305-653-6365
Mailing Address - Fax:305-653-7445
Practice Address - Street 1:65 NW 168TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-6027
Practice Address - Country:US
Practice Address - Phone:305-653-6365
Practice Address - Fax:305-653-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045322600Medicaid
FL96666Medicare PIN