Provider Demographics
NPI:1356725147
Name:CLAUDIA D. MARCELO, D.O., P.A.
Entity type:Organization
Organization Name:CLAUDIA D. MARCELO, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARCELO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-546-3791
Mailing Address - Street 1:4401 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3513
Mailing Address - Country:US
Mailing Address - Phone:813-546-3791
Mailing Address - Fax:
Practice Address - Street 1:1761 NE 42ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-5463
Practice Address - Country:US
Practice Address - Phone:813-546-3791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-12
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty