Provider Demographics
NPI:1740205145
Name:MARKER, GARY DONALD (AP)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:DONALD
Last Name:MARKER
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TANGELO ISLE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1659
Mailing Address - Country:US
Mailing Address - Phone:954-817-6120
Mailing Address - Fax:
Practice Address - Street 1:1919 NE 45TH ST
Practice Address - Street 2:SUITE 122
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5131
Practice Address - Country:US
Practice Address - Phone:954-817-6120
Practice Address - Fax:954-776-7160
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 794171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist