MARATHON HEALTH LLC NPI 1942740675

NPI Information

  • NPI: 1942740675
  • Provider Name: MARATHON HEALTH, LLC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Other Name: MARATHON HEALTH AT BREVARD NORTH
  • CLIA Number: 23D2284978
  • Address: 1505 KNOX MCRAE DRIVE
    C/O BREVARD WELLCARE- NORTH
    TITUSVILLE, FL
    ZIP 32780
  • Phone: (802) 857-0400

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NPI Details

MARATHON HEALTH, LLC is a general practice in Titusville, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MARATHON HEALTH, LLC NPI is 1942740675. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Marathon Health At Brevard North.

The provider's business location address is:

1505 KNOX MCRAE DRIVE
C/O BREVARD WELLCARE- NORTH
TITUSVILLE, FL
ZIP 32780
Phone: (802) 857-0400

The provider's authorized official is Jerry Ford .
The authorized official title is Ceo and has the following contact phone number (802) 857-0400.

The CLIA number assigned to this NPI record is 23D2284978 - other - onsite health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2017 and was last updated on 2/28/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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