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Individual

MARINO AMAURY CHANLATTE-ITHIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
483 N SEMORAN BLVD, STE #103, WINTER PARK, FL 32792-3800
(407) 680-2273
(321) 274-0224
Mailing address
483 N SEMORAN BLVD, STE #103, WINTER PARK, FL 32792-3800
(407) 680-2273
(321) 274-0224

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
12726
PR
207P00000X
Emergency Medicine Physician
Primary
ME117097
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009431000
FL
Enumeration date
04/12/2011
Last updated
07/01/2016
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