Provider Demographics
NPI:1831551670
Name:MARIMON PEDIATRICS LLC
Entity type:Organization
Organization Name:MARIMON PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:GILMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-600-4733
Mailing Address - Street 1:3661 S MIAMI AVE STE 803
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4214
Mailing Address - Country:US
Mailing Address - Phone:786-600-4733
Mailing Address - Fax:786-724-4889
Practice Address - Street 1:3661 S MIAMI AVE STE 803
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4214
Practice Address - Country:US
Practice Address - Phone:786-600-4733
Practice Address - Fax:786-724-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115028208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty