Healthcare Provider Details

I. General information

NPI: 1801336383
Provider Name (Legal Business Name): MARLENE MARIA VELASQUEZ-SEDITO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 UNIVERSITY BLVD SUITE #211
JUPITER FL
33458-2791
US

IV. Provider business mailing address

20 CELESTIAL WAY APT. #308
JUNO BEACH FL
33408-2372
US

V. Phone/Fax

Practice location:
  • Phone: 561-253-8121
  • Fax: 561-253-8021
Mailing address:
  • Phone: 305-776-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP1647662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: