Provider Demographics
NPI:1619054103
Name:AKERMAN, MARCOS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:
Last Name:AKERMAN
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:PO BOX 2482
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33008-2482
Mailing Address - Country:US
Mailing Address - Phone:954-458-2636
Mailing Address - Fax:954-458-6979
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 504
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4722
Practice Address - Country:US
Practice Address - Phone:954-458-2636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76672208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG8574Medicare UPIN