Provider Demographics
NPI:1033474911
Name:MARATHON VERTERINARY HOSPITAL INC.
Entity Type:Organization
Organization Name:MARATHON VERTERINARY HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF STAFF
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETHELM-MADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-743-7099
Mailing Address - Street 1:11187 OVERSEAS HWY
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3460
Mailing Address - Country:US
Mailing Address - Phone:305-743-7099
Mailing Address - Fax:305-743-4057
Practice Address - Street 1:11187 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3460
Practice Address - Country:US
Practice Address - Phone:305-743-7099
Practice Address - Fax:305-743-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM 7228284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital