Provider Demographics
NPI:1265876692
Name:MARVIN MORDES, M.D., P.A.
Entity type:Organization
Organization Name:MARVIN MORDES, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-209-1086
Mailing Address - Street 1:4920 LORING DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8052
Mailing Address - Country:US
Mailing Address - Phone:561-209-1086
Mailing Address - Fax:561-209-6355
Practice Address - Street 1:4920 LORING DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8052
Practice Address - Country:US
Practice Address - Phone:561-209-1086
Practice Address - Fax:561-209-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME875702084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty