Provider Demographics
NPI:1518915719
Name:MARHOLIN, MAURICE DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:DAVID
Last Name:MARHOLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4327 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5349
Mailing Address - Country:US
Mailing Address - Phone:352-989-5901
Mailing Address - Fax:352-989-5902
Practice Address - Street 1:221 N. HIGHWAY 27
Practice Address - Street 2:SUITE G
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5902
Practice Address - Country:US
Practice Address - Phone:352-989-5901
Practice Address - Fax:352-989-5902
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 7330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000252501Medicaid
FL70446VMedicare PIN