Provider Demographics
NPI:1679651665
Name:MARRACCINI, JOHN V (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:MARRACCINI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6280 SUNSET DR
Mailing Address - Street 2:SUITE 407
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4827
Mailing Address - Country:US
Mailing Address - Phone:305-666-8858
Mailing Address - Fax:305-665-1731
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:SUITE 407
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-666-8858
Practice Address - Fax:305-665-1731
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2019-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME36275207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF31726Medicare UPIN