Provider Demographics
NPI:1619002888
Name:MARCUS, JONATHAN EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EVAN
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1875 NW CORPORATE BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8542
Mailing Address - Country:US
Mailing Address - Phone:561-997-0821
Mailing Address - Fax:561-997-0849
Practice Address - Street 1:1875 NW CORPORATE BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8542
Practice Address - Country:US
Practice Address - Phone:561-997-0821
Practice Address - Fax:561-997-0849
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07718100207R00000X, 207RC0200X
FLME101167207RC0200X
NC2014-02066207RC0200X, 207RC0200X
NJ25MA077181207RP1001X
VA0101251644207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease