Provider Demographics
NPI:1285685115
Name:KESSELMAN, MARC M (DO)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:M
Last Name:KESSELMAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1235 FUNSTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2217
Mailing Address - Country:US
Mailing Address - Phone:305-610-1517
Mailing Address - Fax:954-922-8819
Practice Address - Street 1:3200 S UNIVERSITY DR BLDG 4128
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-4100
Practice Address - Fax:954-922-8819
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 5032207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82925WMedicare ID - Type Unspecified
FLD60768Medicare UPIN