Provider Demographics
NPI:1083732622
Name:JANET MARLEY M.D.,P.A.
Entity Type:Organization
Organization Name:JANET MARLEY M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-885-1418
Mailing Address - Street 1:5516 HANLEY RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4904
Mailing Address - Country:US
Mailing Address - Phone:813-885-1418
Mailing Address - Fax:813-886-6731
Practice Address - Street 1:5516 HANLEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4904
Practice Address - Country:US
Practice Address - Phone:813-885-1418
Practice Address - Fax:813-886-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026208174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty