Healthcare Provider Details

I. General information

NPI: 1114848199
Provider Name (Legal Business Name): MARISOL NARANJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 37TH ST
VERO BEACH FL
32960-4863
US

IV. Provider business mailing address

253 S CYPRESS ST
FELLSMERE FL
32948-6723
US

V. Phone/Fax

Practice location:
  • Phone: 772-778-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA18826
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: