Provider Demographics
NPI:1659726289
Name:DELVINA, MARLIN (DO)
Entity type:Individual
Prefix:
First Name:MARLIN
Middle Name:
Last Name:DELVINA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-1900
Mailing Address - Fax:239-424-1908
Practice Address - Street 1:224 SANTA BARBARA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2038
Practice Address - Country:US
Practice Address - Phone:239-424-1900
Practice Address - Fax:239-424-1908
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15680208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103495100Medicaid