Healthcare Provider Details

I. General information

NPI: 1992653745
Provider Name (Legal Business Name): ANELKIS MARIELL VIEIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 BALSAM ST
PALM BEACH GARDENS FL
33410-4809
US

IV. Provider business mailing address

316 BALSAM ST
PALM BEACH GARDENS FL
33410-4809
US

V. Phone/Fax

Practice location:
  • Phone: 561-890-5776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11046162
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: