Provider Demographics
NPI:1659639136
Name:MACAU, MARCOS ANTONIO (DOM)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:ANTONIO
Last Name:MACAU
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 SW 81ST DR
Mailing Address - Street 2:#201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6603
Mailing Address - Country:US
Mailing Address - Phone:305-301-3738
Mailing Address - Fax:
Practice Address - Street 1:8100 SW 81ST DR
Practice Address - Street 2:#201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-6603
Practice Address - Country:US
Practice Address - Phone:305-301-3738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist