Individual
GREGORY Q MARSELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8000 N FEDERAL HWY STE 110, BOCA RATON, FL 33487-1681
(561) 394-2532
(561) 210-1371
Mailing address
3648 MYKONOS CT, BOCA RATON, FL 33487-1295
(561) 789-9922
(561) 210-1371
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME51261
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04790
MEDICARE PTAN
FL
01
—
04790A
MEDICARE PTAN
FL
05
—
376683700
—
FL
Enumeration date
10/09/2006
Last updated
04/01/2024
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