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NPI Code Detail

MEDICARE: MARIE SHERLINE RIDORE NP

MEDICARE: MARIE SHERLINE RIDORE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN9327097FL
2163W00000XRegistered Nurse9327097FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477051506
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE SHERLINE RIDORE NP
Provider Business Mailing Address
First Line : 9400 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33150-2025
Country : US
Telephone Number : 786-321-2399
Fax Number :
Provider Business Practice Location Address
First Line : 9400 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33150-2025
Country : US
Telephone Number : 786-321-2399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2018
Last Update Date : 09/25/2022

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Directions to “ MARIE SHERLINE RIDORE NP” Practice Location

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