# MITCHELL J MARDER P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235491820
- **Authorized official:** DR. MITCHELL J MARDER O.D. (PRESIDENT)
- **Authorized official phone:** (561) 445-3086

## Contact information

- **Practice address:** 4923 COCONUT CREEK PKWY, COCONUT CREEK, FL 33063-3909
- **Practice address phone:** (954) 970-4266
- **Mailing address:** 11368 ISLAND LAKES LN, BOCA RATON, FL 33498-6805
- **Mailing address phone:** (561) 445-3086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC001674 | FL | Yes |

## Other

- **Enumeration date:** 06/11/2012
- **Last updated:** 06/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078119100 | — | FL |