Provider Demographics
NPI:1316943491
Name:RAYMOND, MARILYN CYNTHIA (MD)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:CYNTHIA
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:ATTN CREDENTIALING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:1309 N FLAGLER DR
Practice Address - Street 2:FLORIDA CANCER SPECIALISTS PL
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3406
Practice Address - Country:US
Practice Address - Phone:561-366-4100
Practice Address - Fax:561-366-4189
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74719207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256340100Medicaid
FL42999WMedicare PIN
FLF62099Medicare UPIN
FL42999XMedicare PIN
FL256340100Medicaid
FL42999VMedicare PIN