Provider Demographics
NPI:1205996659
Name:MARION HEALTH CENTER
Entity type:Organization
Organization Name:MARION HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANTHOUSIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-351-2202
Mailing Address - Street 1:18552 KINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2708
Mailing Address - Country:US
Mailing Address - Phone:352-351-2202
Mailing Address - Fax:352-351-2422
Practice Address - Street 1:600 SW 10TH ST STE 202
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-2600
Practice Address - Country:US
Practice Address - Phone:352-351-2202
Practice Address - Fax:352-351-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39480208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty