Provider Demographics
NPI:1346966264
Name:NATIONSMARKET, LLC
Entity Type:Organization
Organization Name:NATIONSMARKET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-939-3290
Mailing Address - Street 1:1801 NW 66TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 66TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4571
Practice Address - Country:US
Practice Address - Phone:954-939-3292
Practice Address - Fax:954-939-3288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONSBENEFITS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals