Provider Demographics
NPI:1295585990
Name:MARION, ZACHARY EDWARD
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:EDWARD
Last Name:MARION
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 GLADES RD # BC-71
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6496
Mailing Address - Country:US
Mailing Address - Phone:561-955-5365
Mailing Address - Fax:561-955-3577
Practice Address - Street 1:800 MEADOWS ROAD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-955-5365
Practice Address - Fax:561-955-3577
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program