Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3725 | FL |
N | 213ES0103X | Foot & Ankle Surgery | RESIDENT | FL |
N | 213ES0103X | Foot & Ankle Surgery | SC006532 | PA |
NPI | 1033406848 |
---|---|
Provider Name | Dr. Jaclyn Marino |
First Address | Miami, FL 33125-1624 |
Second Address | Miami, FL 33125-1624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 02/06/2015 |