Provider Demographics
NPI:1730183435
Name:FLORIDA, MARLON A (MD)
Entity type:Individual
Prefix:DR
First Name:MARLON
Middle Name:A
Last Name:FLORIDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 786
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35201-0786
Mailing Address - Country:US
Mailing Address - Phone:866-313-5265
Mailing Address - Fax:205-313-5298
Practice Address - Street 1:210 W AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2804
Practice Address - Country:US
Practice Address - Phone:205-313-5265
Practice Address - Fax:205-313-5298
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL24104207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51055195OtherCHG BCBSAL
AL51510275OtherSHO BCBSAL
H08131Medicare UPIN