Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 163460 | FL |
Y | 207RP1001X | Pulmonary Disease | G72937 | CA |
N | 207RS0012X | Sleep Medicine | 163460 | FL |
NPI | 1013975119 |
---|---|
Provider Name | Dr. Peter A Marco |
First Address | Pensacola, FL 32504 |
Second Address | Pensacola, FL 32504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 29/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G72937 | CALIFORNIA STATE LICENSE (01) | CA |
ME107733 | FLORIDA STATE LICENSE (01) | FL |