Anelisse Marino, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN20192 Issued in FL

Practice address

1209 W Broward Blvd
Fort Lauderdale, FL 33312-1640

Phone

(954) 763-3358

NPI assigned

Dec 12, 2013

Sex

Female

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marino Family Dental LLC

  • Dental Clinic/Center
  • Lauderhill, FL
  • NPI 1336652858
  NPD (past) Authorized official
• Michael Barnard DDS PA

  • Dentist
  • Ft Lauderdale, FL
  • NPI 1427264936
  NPD (past)

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1487085668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 NW 107TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333222528",
            "telephone_number": "813-833-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121640",
            "telephone_number": "954-763-3358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4506 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Lauderhill",
            "state": "FL",
            "postal_code": "333515740",
            "country_code": "US",
            "telephone_number": "954-386-7500",
            "fax_number": "954-386-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINO",
        "first_name": "ANELISSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015087600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaelanne Marie, PSYD
• Claudia Marin, A.P.
• Juan Pablo Marin
• Laura Marin
• Martina Marini, LCSW
• Marisabel Olivera, DMD, PA
• Mark Bernhardt, MD, PA
• Nabeel Markatia, MD
• Evan Tobias Markell, PA-C
• Gary Donald Marker, A.P.

• Dentist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.