Mariusz J Klin M D P a

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME85851 Issued in FL

Legal business name

MARIUSZ J KLIN M D P A

Practice address

2202 State Ave
Suite 301
Panama City, FL 32405-7601

Phone

(850) 215-7071

Fax

(850) 215-7073

NPI assigned

Jul 28, 2008

Organization subpart

No

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

Authorized official

Name

Stephne Ann Blackwell

Title

Office Manager

Phone

(850) 215-7071

Specialties & licenses 1

Addresses

Other names 1

• Emerald Coast Gastroenterology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mariusz Jerzy Klin, MD, PHD

  • Gastroenterology Physician
  • Pensacola, FL
  • NPI 1457357006
  Medicare reassignment NPD
• Laura Rizzo Bracey, ARNP

  • Family Nurse Practitioner
  • Panama City, FL
  • NPI 1366456451
  NPD

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1508021684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE",
            "address_2": "SUITE 301",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057601",
            "telephone_number": "850-215-7071",
            "fax_number": "850-215-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE",
            "address_2": "SUITE 301",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057601",
            "telephone_number": "850-215-7071",
            "fax_number": "850-215-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIUSZ J KLIN M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "STEPHNE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-215-7071"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME85851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Coast Gastroenterology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Connor Maraziti, APRN
• Peter A Marco, M.D.
• Natalie Yvonne Marcum
• Marina Pointe Dental PLLC
• Marion J Mathews MD PA
• Mark D. White D.C. P.a.
• Allen Dale Marks, LMHC
• Sarah Markwood
• Diane Suzette Marshall, LMHC
• Charles Brent Martin, M.S., BCBA

• Gastroenterology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.