Provider Demographics
NPI:1518986421
Name:MARON, CHARLES SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SCOTT
Last Name:MARON
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 1:15875 SW 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-2426
Mailing Address - Country:US
Mailing Address - Phone:786-293-2837
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12 AVE
Practice Address - Street 2:JACKSON MEMORIAL HOSPITAL
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-585-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42318207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine