Healthcare Provider Details

I. General information

NPI: 1245738566
Provider Name (Legal Business Name): MARJORIE MERCIE GEDEON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NORTHPOINT PKWY STE 95
WEST PALM BEACH FL
33407-1812
US

IV. Provider business mailing address

139 TWO PINE DR
GREENACRES FL
33413-2500
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-6111
  • Fax:
Mailing address:
  • Phone: 305-335-4920
  • Fax: 863-222-9343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9253458
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: