Provider Demographics
NPI:1275762163
Name:MARATHON HEALTH CARE SERVICES OF FLORIDA PA
Entity Type:Organization
Organization Name:MARATHON HEALTH CARE SERVICES OF FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:CARMEL
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:813-637-5700
Mailing Address - Street 1:354 MOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5968
Mailing Address - Country:US
Mailing Address - Phone:802-857-0400
Mailing Address - Fax:805-655-3607
Practice Address - Street 1:8125 HIGHWOODS PALM WAY
Practice Address - Street 2:C/O SYNIVERSE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1776
Practice Address - Country:US
Practice Address - Phone:813-637-5700
Practice Address - Fax:813-637-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site