Provider Demographics
NPI:1255192688
Name:GIA MAROTTA MD PA
Entity type:Organization
Organization Name:GIA MAROTTA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-905-2841
Mailing Address - Street 1:PO BOX 631430
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963-1430
Mailing Address - Country:US
Mailing Address - Phone:305-905-2841
Mailing Address - Fax:
Practice Address - Street 1:2400 N STALLINGS D SUITE 20
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75064-0001
Practice Address - Country:US
Practice Address - Phone:305-905-2841
Practice Address - Fax:305-905-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty