Provider Demographics
NPI:1225452618
Name:VANESSA C. MARINO, O.D., P.A.
Entity Type:Organization
Organization Name:VANESSA C. MARINO, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:CARIDAD
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-233-2040
Mailing Address - Street 1:8353 SW 124TH ST STE 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5847
Mailing Address - Country:US
Mailing Address - Phone:305-233-2040
Mailing Address - Fax:305-233-2052
Practice Address - Street 1:8353 SW 124TH ST STE 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5847
Practice Address - Country:US
Practice Address - Phone:305-233-2040
Practice Address - Fax:305-233-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4223152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty