Active NPI
Guillermo Manuel Marin I, SURGICAL ASSISTANT
- Surgical Assistant
- Palm Springs, FL
National Provider Identifier
1912147000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 09109
- Practice address
- 3526 Canal Rd
Palm Springs, FL 33461-3533 - Phone
- (561) 541-9097
- Fax
- (561) 966-5436
- NPI assigned
- Mar 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 09109 | FL | Primary |
Addresses
Primary practice location
3526 Canal Rd
Palm Springs, FL 33461-3533
Mailing address
3526 Canal Rd
Palm Springs, FL 33461-3533
Phone (561) 541-9097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000000 | Other | FL | 000000000 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09109 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1912147000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3526 CANAL RD",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334613533",
"telephone_number": "561-541-9097",
"fax_number": "561-966-5436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3526 CANAL RD",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334613533",
"telephone_number": "561-541-9097",
"fax_number": "561-966-5436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIN",
"first_name": "GUILLERMO",
"middle_name": "MANUEL",
"name_prefix": "Mr.",
"name_suffix": "I",
"credential": "SURGICAL ASSISTANT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-02",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "09109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "000000000",
"identifier": "00000000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.