Healthcare Provider Details

I. General information

NPI: 1831994805
Provider Name (Legal Business Name): NADIA MARCELLUS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7807 SW 8TH CT # A
NORTH LAUDERDALE FL
33068-2230
US

IV. Provider business mailing address

7807 SW 8TH CT # A
NORTH LAUDERDALE FL
33068-2230
US

V. Phone/Fax

Practice location:
  • Phone: 954-548-1178
  • Fax:
Mailing address:
  • Phone: 954-548-1178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11035138
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: