Healthcare Provider Details

I. General information

NPI: 1700599149
Provider Name (Legal Business Name): MARIA BOONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1796 HWY 441 NORTH
OKEECHOBEE FL
34974
US

IV. Provider business mailing address

8775 SE 57TH DR
OKEECHOBEE FL
34974-1752
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-2151
  • Fax:
Mailing address:
  • Phone: 863-447-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11024167
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN9460918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: