Basic Information
| Provider Information | |||||||||
| NPI: | 1861466054 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARCUS | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | ELLIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7646 NOB HILL ROAD | ||||||||
| Address2: | |||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333211869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544840800 | ||||||||
| FaxNumber: | 9547216370 | ||||||||
| Practice Location | |||||||||
| Address1: | 7646 NOB HILL ROAD | ||||||||
| Address2: | |||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333211869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544840800 | ||||||||
| FaxNumber: | 9547216370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 08/28/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME36274 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.