Individual provider Active NPI

Mitchell L Marks, D.O.

  • Internal Medicine Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1972599199
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS5567 Issued in FL
Practice address
3345 Burns Rd
Ste 101
Palm Beach Gardens, FL 33410-4304
Phone
(561) 622-2022
Fax
(561) 622-6775
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS5567 FL Primary

Addresses

Primary practice location

3345 Burns Rd
Ste 101
Palm Beach Gardens, FL 33410-4304

Mailing address

3345 Burns Rd
Ste 101
Palm Beach Gardens, FL 33410-4304
Phone (561) 622-2022

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)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1972599199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD",
            "address_2": "STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104304",
            "telephone_number": "561-622-2022",
            "fax_number": "561-622-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD",
            "address_2": "STE 101",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104304",
            "telephone_number": "561-622-2022",
            "fax_number": "561-622-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "MITCHELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS5567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.