Organization
BERTHA MARCELLINO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTHA L MARCELLINO M.D. (OWNER)
(561) 514-5486
Entity
Organization
Contact information
Practice address
3003 S CONGRESS AVE, SUITE 1C, PALM SPRINGS, FL 33461-2169
(561) 433-3460
(561) 433-3828
Mailing address
2860 S OCEAN BLVD APT 509, PALM BEACH, FL 33480-5562
(561) 586-5083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME92093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2726165101
—
FL
Enumeration date
07/24/2007
Last updated
10/08/2010
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