# MARLEY MEDICAL PROVIDER GROUP, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Starlight Provider Group, P.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487301917
- **Authorized official:** DR. VIKRAM DEEPAK BAKHRU MD (PRESIDENT)
- **Authorized official phone:** (888) 811-9064

## Contact information

- **Practice address:** 2332 GALIANO ST FL 2, CORAL GABLES, FL 33134-5402
- **Practice address phone:** (305) 998-0713
- **Mailing address:** 2332 GALIANO ST FL 2, CORAL GABLES, FL 33134-5402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 03/04/2022
- **Last updated:** 06/23/2025