Kisha F. Marzouca, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME90515 Issued in FL

Practice address

1150 45TH St
West Palm Beach, FL 33407-2361

Phone

(561) 642-1000

NPI assigned

Oct 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1376532101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7207 IVY CROSSING LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334369417",
            "telephone_number": "561-358-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072361",
            "telephone_number": "561-642-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOUCA",
        "first_name": "KISHA",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME90515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269853600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marvin Mordes, M.D., P.a.
• Chelsey Marx, COTA
• Mary K Tatum
• Mary M. Colburn, M.D., P.a.
• Pascale Mary, APRN
• Meibol Mas San Juan
• Angelie Mascarinas, M.D.
• Angela Mason, DPT/OT
• Claudia E Mason, MD
• Jatara Latoi Mason, LMHC

• Pediatrics Physician in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.