Individual
DR. MARC PATRICK UNDERHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01069066A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
ME143305
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106130600
—
FL
05
—
201011260
—
IN
01
—
M400062727
MEDICARE SVMG
IN
01
—
MH000
MEDICARE PTAN OHRI
FL
01
—
NDWHR
BCBS
FL
01
—
PS688
MEDICARE PTAN OHMG
FL
Enumeration date
05/24/2007
Last updated
03/28/2023
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