Marine Park LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH31059 Issued in FL

Legal business name

MARINE PARK LLC

Doing business as

Marine Pharmacy

Practice address

3514 Broadway
Riviera Beach, FL 33404-2332

Phone

(561) 782-7575

Fax

(855) 230-7564

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Diana Vanessa Rodriguez

Title

MGR

Phone

(954) 552-2242

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• MARINE PHARMACY Doing business as
• DIDI RX, LLC Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1558876094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 BROADWAY",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334042332",
            "telephone_number": "561-782-7575",
            "fax_number": "855-230-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 BROADWAY",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334042332",
            "telephone_number": "561-782-7575",
            "fax_number": "855-230-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "VANESSA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "954-552-2242"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH31059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100328900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177735",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARINE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DIDI RX, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mama Knowles Best Family Daycare LLC (Sunshines Home Health Services)
• Epimaelene Portia Pasigna Mangila
• Linda Maniscalco
• Veronica Manzanares
• Merry Wendy Marcelin, MSW, RCSW-I
• Olivia Marino, M.S.
• Justin Marlett
• Cheryl Marshall, RN
• Frances Diane Marshall, RN,MSN
• Chelsea T Martell, LCSW

• Community/Retail Pharmacy in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.