NPIMap

Organization Active NPI

Indira Marmolejos MD PA

Doing business as Palm Beach Infectious Diseases

  • Infectious Disease Physician
  • Delray Beach, FL
National Provider Identifier
1174829121
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME99093 Issued in FL
Legal business name
INDIRA MARMOLEJOS MD PA
Doing business as
Palm Beach Infectious Diseases
Practice address
6238 W Atlantic Ave
Suite 2
Delray Beach, FL 33484-3501
Phone
(561) 404-9845
Fax
(561) 404-9849
NPI assigned
Feb 8, 2011
Last updated
Jul 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Indira Maribel Marmolejos, M.DNPI 1659535987
Title
President
Phone
(561) 404-9845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X ME99093 FL Primary

Addresses

Primary practice location

6238 W Atlantic Ave
Suite 2
Delray Beach, FL 33484-3501

Mailing address

6238 W Atlantic Ave
Suite 2
Delray Beach, FL 33484-3501
Phone (561) 404-9845

Other identifiers 1

IdentifierTypeStateIssuer
001469700MedicaidFL

Other names 1

  • Palm Beach Infectious Diseases Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110721000615 FL Part B Supplier - Clinic/Group Practice 4789852567 Receives reassigned benefits from 5 practitioners
Practice locations: Delray Beach, FL

National Provider Directory

National Provider Directory

Locations

2605 W Atlantic Ave
Ste D101
Delray Beach, FL 33445
Phone (561) 279-0991

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1174829121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6238 W ATLANTIC AVE",
            "address_2": "SUITE 2",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334843501",
            "telephone_number": "561-404-9845",
            "fax_number": "561-404-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6238 W ATLANTIC AVE",
            "address_2": "SUITE 2",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334843501",
            "telephone_number": "561-404-9845",
            "fax_number": "561-404-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIRA MARMOLEJOS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "MARMOLEJOS",
        "authorized_official_first_name": "INDIRA",
        "authorized_official_middle_name": "MARIBEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-404-9845",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME99093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001469700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Beach Infectious Diseases",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.