Provider Demographics
NPI:1912000191
Name:MARROCCO, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:MARROCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:MARROCCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:103 HALF MOON CIR
Mailing Address - Street 2:SUITE E1
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-5477
Mailing Address - Country:US
Mailing Address - Phone:561-537-0514
Mailing Address - Fax:
Practice Address - Street 1:103 HALF MOON CIR
Practice Address - Street 2:SUITE E1
Practice Address - City:HYPOLUXO
Practice Address - State:FL
Practice Address - Zip Code:33462-5477
Practice Address - Country:US
Practice Address - Phone:561-537-0514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052282208200000X
FLME95032202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G61580Medicare UPIN
187530Medicare PIN