Healthcare Provider Details

I. General information

NPI: 1689422727
Provider Name (Legal Business Name): MARIVIE PAREDES BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 SURGEONS DR
TALLAHASSEE FL
32308-4631
US

IV. Provider business mailing address

501 S BLAIR STONE RD APT 208
TALLAHASSEE FL
32301-3025
US

V. Phone/Fax

Practice location:
  • Phone: 850-566-6600
  • Fax:
Mailing address:
  • Phone: 850-566-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number9591174
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: