Healthcare Provider Details

I. General information

NPI: 1174264824
Provider Name (Legal Business Name): MARLINE FRANCOIS-DECAMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 STIRRUP KEY BLVD
MARATHON FL
33050-2943
US

IV. Provider business mailing address

6800 SW 3RD ST
MARGATE FL
33068-1547
US

V. Phone/Fax

Practice location:
  • Phone: 954-363-1011
  • Fax:
Mailing address:
  • Phone: 954-895-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11019068
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9256983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: