Provider Demographics
NPI:1497799761
Name:SZOMSTEIN, MARCOS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:
Last Name:SZOMSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7765 SW 87TH AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2596
Mailing Address - Country:US
Mailing Address - Phone:305-596-3080
Mailing Address - Fax:305-596-3073
Practice Address - Street 1:7765 SW 87TH AVE
Practice Address - Street 2:SUITE 212A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2596
Practice Address - Country:US
Practice Address - Phone:305-596-3080
Practice Address - Fax:305-596-3073
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72681208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020964OtherNEIGHBORHOOD HEALTH
FL38089OtherBLUE CROSS BLUE SHIELD
FL171163OtherWELLCARE
FL252382500Medicaid
FL5635493OtherAETNA PPO
FL2114515OtherAETNA HMO
FL250334OtherAVMED
FLG41312Medicare UPIN
FL171163OtherWELLCARE