Provider Demographics
NPI:1679659734
Name:FLETCHER, MARLENE S (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:S
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6447 MIAMI LAKES DR E
Mailing Address - Street 2:STE. 210G
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2741
Mailing Address - Country:US
Mailing Address - Phone:305-826-3535
Mailing Address - Fax:305-826-3737
Practice Address - Street 1:6447 MIAMI LAKES DR E
Practice Address - Street 2:STE. 210G
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2741
Practice Address - Country:US
Practice Address - Phone:305-826-3535
Practice Address - Fax:305-826-3737
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 45221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine