Provider Demographics
NPI:1821041252
Name:POLICARD, MARIE CHANTAL (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:CHANTAL
Last Name:POLICARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4804
Mailing Address - Country:US
Mailing Address - Phone:305-662-2792
Mailing Address - Fax:305-662-2341
Practice Address - Street 1:6285 SUNSET DR
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4804
Practice Address - Country:US
Practice Address - Phone:305-662-2792
Practice Address - Fax:305-662-2341
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87073207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78685YMedicare ID - Type Unspecified
FLH84487Medicare UPIN