Provider Demographics
NPI:1063694495
Name:FRANCIS, MARLON (RPH)
Entity type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 OKEECHOBEE BLVD
Mailing Address - Street 2:#207
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6060
Mailing Address - Country:US
Mailing Address - Phone:347-276-1703
Mailing Address - Fax:
Practice Address - Street 1:9921 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1899
Practice Address - Country:US
Practice Address - Phone:561-793-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051473183500000X
FLPS43543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist