Healthcare Provider Details

I. General information

NPI: 1679337547
Provider Name (Legal Business Name): MARA CIJULUS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SEASHORE DR
JUPITER FL
33477-9687
US

IV. Provider business mailing address

308 NW FRIAR ST
PORT SAINT LUCIE FL
34983-1572
US

V. Phone/Fax

Practice location:
  • Phone: 561-677-9658
  • Fax: 561-658-4541
Mailing address:
  • Phone: 561-598-2671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11031133
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: