Provider Demographics
NPI:1184434847
Name:CARLA MARINELLO PA
Entity type:Organization
Organization Name:CARLA MARINELLO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-587-7554
Mailing Address - Street 1:4520 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3771
Mailing Address - Country:US
Mailing Address - Phone:786-587-7554
Mailing Address - Fax:
Practice Address - Street 1:4520 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3771
Practice Address - Country:US
Practice Address - Phone:786-587-7554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty