Healthcare Provider Details

I. General information

NPI: 1982640983
Provider Name (Legal Business Name): MARIE MESSINA CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5124 SESAME ST
PALM BEACH GARDENS FL
33418-3521
US

IV. Provider business mailing address

5124 SESAME ST
PALM BEACH GARDENS FL
33418-3521
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-5134
  • Fax: 561-626-3963
Mailing address:
  • Phone: 561-626-5134
  • Fax: 561-626-3963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number1818332
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: