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Organization
MARLEY MEDICAL PROVIDER GROUP, P.A.
Active
Organization
MARLEY MEDICAL PROVIDER GROUP, P.A.
Active
Other names
Starlight Provider Group, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIKRAM DEEPAK BAKHRU MD (PRESIDENT)
(888) 811-9064
Entity
Organization
Contact information
Practice address
2332 GALIANO ST FL 2, CORAL GABLES, FL 33134-5402
(305) 998-0713
Mailing address
2332 GALIANO ST FL 2, CORAL GABLES, FL 33134-5402
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
03/04/2022
Last updated
06/23/2025
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