Healthcare Provider Details

I. General information

NPI: 1487165163
Provider Name (Legal Business Name): MARINA RYAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 UNIVERSITY BLVD STE 104
JUPITER FL
33458-2778
US

IV. Provider business mailing address

600 UNIVERSITY BLVD STE 104
JUPITER FL
33458-2778
US

V. Phone/Fax

Practice location:
  • Phone: 561-331-1996
  • Fax: 561-629-5560
Mailing address:
  • Phone: 561-331-1996
  • Fax: 561-629-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9310760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: