Provider Demographics
NPI:1275671489
Name:MARVEL, KARL (DO)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:
Last Name:MARVEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7037 US HIGHWAY 301 S
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-4344
Mailing Address - Country:US
Mailing Address - Phone:813-677-0229
Mailing Address - Fax:813-677-0137
Practice Address - Street 1:7037 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-4344
Practice Address - Country:US
Practice Address - Phone:813-677-0229
Practice Address - Fax:813-677-0137
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO3877156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician