Desantis, Marshall Matthew

Desantis, Marshall Matthew is an sole proprietor health care provider with primary practice located at 14100 Fivay Rd Suite 300, Hudson FL 34667-7180. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Desantis, Marshall Matthew can be contacted via phone (727) 869-7497.

Contact Information

Primary practice address
14100 Fivay Rd Suite 300 Hudson FL 34667-7180
Phone: (727) 869-7497
Fax: (727) 869-7156
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X ME0053627 Florida
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X ME53627 Florida

Profile Details

NPI number 1467542498
LBN Legal business name Desantis, Marshall Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2006
Last updated May 27th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467542498 NPPES
Florida Other 07035 BCBS FLORIDA
Florida Other 083596 BCBS FLORIDA
Florida MEDICAID 048693100 BCBS FLORIDA

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