Provider Demographics
NPI:1295917763
Name:MAGSINO, MARISSA E (MD)
Entity type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:E
Last Name:MAGSINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7450 DR. PHILLIPS BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-292-6778
Mailing Address - Fax:407-292-5297
Practice Address - Street 1:7450 DR PHILLIPS BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-292-6778
Practice Address - Fax:407-292-5297
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2016-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME72766207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253614500Medicaid
FL253614500Medicaid
FLG64390Medicare UPIN