MEDICARE: MARIE ELIE

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
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1730643230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE ELIE

Provider Business Mailing Address
First Line	:	3480 SOHO ST APT B06
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-7538
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 DELANEY AVE STE 5
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-3866
Country	:	US
Telephone Number	:	321-247-5165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2019
Last Update Date	:	01/29/2019

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Directions to “ MARIE ELIE ” Practice Location

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