Individual
PEDRO A MARCUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18900 N TAMIAMI TRL, SUITE A12, NORTH FORT MYERS, FL 33903-7312
(239) 458-0168
(239) 458-3925
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7382
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME86865
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57661
BCBS OF FLORIDA PROV. #
FL
01
—
7016304
AETNA PROVIDER #
FL
01
—
8892692
CIGNA PROVIDER #
FL
01
—
P00445995
RAILROAD MEDICARE
FL
Enumeration date
08/05/2006
Last updated
06/08/2009
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