Provider Demographics
NPI:1780030130
Name:MARRONE, SAMANTHA ALEXA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ALEXA
Last Name:MARRONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:70 W GORE ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1124
Mailing Address - Country:US
Mailing Address - Phone:407-581-2888
Mailing Address - Fax:407-481-0073
Practice Address - Street 1:70 W GORE ST STE 200A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1124
Practice Address - Country:US
Practice Address - Phone:407-581-2888
Practice Address - Fax:407-481-0073
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137599207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology