Provider Demographics
NPI:1619002888
Name:MARCUS, JONATHAN EVAN (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EVAN
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22278 LARKSPUR TRL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4808
Mailing Address - Country:US
Mailing Address - Phone:201-446-4716
Mailing Address - Fax:
Practice Address - Street 1:22278 LARKSPUR TRL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4808
Practice Address - Country:US
Practice Address - Phone:201-446-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA077181207RP1001X
VA0101251644207RC0200X
FLME101167207RC0200X
NJ25MA07718100207RC0200X, 207R00000X
NC2014-02066207RC0200X
AZ47094207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine