Provider Demographics
NPI:1073510269
Name:ST JOHN, MARCUS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:
Last Name:ST JOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:STE 501
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2132
Mailing Address - Country:US
Mailing Address - Phone:305-412-3558
Mailing Address - Fax:305-412-3515
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:STE 501
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2132
Practice Address - Country:US
Practice Address - Phone:305-412-3558
Practice Address - Fax:305-412-3515
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME90609207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL#009353000Medicaid
FLU3262WMedicare PIN
I17957Medicare UPIN