Provider Demographics
NPI:1730183435
Name:FLORIDA, MARLON A (MD)
Entity type:Individual
Prefix:DR
First Name:MARLON
Middle Name:A
Last Name:FLORIDA
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 1:2814 COUNTY ROAD 63
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-6010
Mailing Address - Country:US
Mailing Address - Phone:256-757-7710
Mailing Address - Fax:256-757-7710
Practice Address - Street 1:2814 COUNTY ROAD 63
Practice Address - Street 2:
Practice Address - City:KILLEN
Practice Address - State:AL
Practice Address - Zip Code:35645-6010
Practice Address - Country:US
Practice Address - Phone:256-757-7710
Practice Address - Fax:256-757-7710
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24732207P00000X
AL24104207P00000X
TNMD52119207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51055195OtherCHG BCBSAL
AL051551705Medicaid
AL51510275OtherSHO BCBSAL
AL051551706Medicaid