Provider Demographics
NPI:1275791584
Name:MICHAEL A MARKS PA
Entity Type:Organization
Organization Name:MICHAEL A MARKS PA
Other - Org Name:SOMERSET CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-488-0225
Mailing Address - Street 1:9325 GLADES RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3988
Mailing Address - Country:US
Mailing Address - Phone:561-488-0225
Mailing Address - Fax:561-488-0722
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:SUITE 108
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-488-0263
Practice Address - Fax:561-488-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU12719Medicare UPIN
FL22481Medicare PIN