Provider Demographics
NPI:1518029214
Name:PENNY, MARZA SMITH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARZA
Middle Name:SMITH
Last Name:PENNY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8005 BAY ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3244
Mailing Address - Country:US
Mailing Address - Phone:772-581-0300
Mailing Address - Fax:772-581-0010
Practice Address - Street 1:8005 BAY ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3244
Practice Address - Country:US
Practice Address - Phone:772-581-0300
Practice Address - Fax:772-581-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2014-04-15
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Provider Licenses
StateLicense IDTaxonomies
FLME0074526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253511400Medicaid
FL253511400Medicaid