| Corporation | |
|
13365 Overseas Hwy Suite 102 Marathon FL 33050 | |
| (305) 743-9436 | |
| (305) 743-9612 |
| Full Name | Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 13365 Overseas Hwy, Marathon, Florida |
| Authorized Official Name and Position | John Patrick Oconnor (OWNER) |
| Authorized Official Contact | 3057439436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 13365 Overseas Hwy Suite 102 Marathon FL 33050 Ph: (305) 743-9436 | Corporation 13365 Overseas Hwy Suite 102 Marathon FL 33050 Ph: (305) 743-9436 |
| NPI Number | 1689750598 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689750598 | NPI | - | NPPES |
| 25759 | Other | FL | BLUE CROSS OF FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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