Provider Demographics
NPI:1851364046
Name:HART, MARLENE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 WINDGUARD CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7369
Mailing Address - Country:US
Mailing Address - Phone:813-731-2966
Mailing Address - Fax:813-991-9196
Practice Address - Street 1:2824 WINDGUARD CIR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7369
Practice Address - Country:US
Practice Address - Phone:813-731-2966
Practice Address - Fax:813-991-9196
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME706622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251583100Medicaid
FL32507XMedicare Oscar/Certification
FL251583100Medicaid
FL32507XMedicare ID - Type Unspecified