Individual provider Active NPI

Priscilla Marzouka

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1639045958
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11042506 Issued in FL
Practice address
13340 SW 119TH St
Miami, FL 33186-4572
Phone
(786) 512-6368
NPI assigned
Oct 14, 2025
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11042506 FL Primary

Addresses

Primary practice location

13340 SW 119TH St
Miami, FL 33186-4572

Mailing address

13340 SW 119TH St
Miami, FL 33186-4572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11042506FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1639045958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13340 SW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13340 SW 119TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864572",
            "telephone_number": "786-512-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOUKA",
        "first_name": "PRISCILLA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11042506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.