Provider Demographics
NPI:1528167301
Name:MARLEY, JANET (MD , PA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MARLEY
Suffix:
Gender:F
Credentials:MD , PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 HANLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634
Mailing Address - Country:US
Mailing Address - Phone:813-885-1418
Mailing Address - Fax:813-886-6731
Practice Address - Street 1:5516 HANLEY ROAD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634
Practice Address - Country:US
Practice Address - Phone:813-885-1418
Practice Address - Fax:813-886-6731
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26208207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069719200Medicaid
FL069719200Medicaid
FLD58462Medicare UPIN