Healthcare Provider Details

I. General information

NPI: 1174934830
Provider Name (Legal Business Name): MARIE VOLINE DUCLAIR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
LAKE PARK FL
33403-2503
US

IV. Provider business mailing address

701 PARK AVE
LAKE PARK FL
33403-2503
US

V. Phone/Fax

Practice location:
  • Phone: 561-568-2739
  • Fax: 949-703-7886
Mailing address:
  • Phone: 561-568-2739
  • Fax: 561-223-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3106482
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3106482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: