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Individual

MARC ADAM MACALUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
400 HEALTH PARK BLVD, SAINT AUGUSTINE, FL 32086-5784
(904) 819-4560
Mailing address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5156
(904) 639-2000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS17966
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118873000
FL
Enumeration date
03/19/2019
Last updated
05/15/2025
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