# MARSAN CLINIC LLC

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

## Provider details

- **NPI number:** 1679245344
- **Authorized official:** MINELY B MARTINEZ MD (PRESIDENT)
- **Authorized official phone:** (407) 933-0305

## Contact information

- **Practice address:** 4693 OLD PLEASANT HILL ROAD, SUITE A, KISSIMMEE, FL 34759
- **Practice address phone:** (407) 933-0305
- **Mailing address:** 4693 OLD PLEASANT HILL ROAD, SUITE A, KISSIMMEE, FL 34759
- **Mailing address phone:** (407) 933-0305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2021
- **Last updated:** 10/01/2021