Provider Demographics
NPI:1205087442
Name:MARINA'S MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:MARINA'S MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ZORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NARVAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-795-4206
Mailing Address - Street 1:PO BOX 14520
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34280-4520
Mailing Address - Country:US
Mailing Address - Phone:941-795-4206
Mailing Address - Fax:941-792-1568
Practice Address - Street 1:5591 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2818
Practice Address - Country:US
Practice Address - Phone:941-795-4206
Practice Address - Fax:941-792-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center