Provider Demographics
NPI:1548400724
Name:MARINO, HAESOOK (MD)
Entity Type:Individual
Prefix:
First Name:HAESOOK
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOOK
Other - Middle Name:
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1825 KINGSLEY AVE STE 390
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4484
Mailing Address - Country:US
Mailing Address - Phone:904-639-2260
Mailing Address - Fax:904-272-1986
Practice Address - Street 1:1825 KINGSLEY AVE STE 390
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4484
Practice Address - Country:US
Practice Address - Phone:904-639-2260
Practice Address - Fax:904-272-1986
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55327207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics