Healthcare Provider Details

I. General information

NPI: 1255549671
Provider Name (Legal Business Name): MARYANNE HOWE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N WYMORE RD SUITE 101
WINTER PARK FL
32789-2859
US

IV. Provider business mailing address

650 N WYMORE RD SUITE 101
WINTER PARK FL
32789-2859
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-4320
  • Fax:
Mailing address:
  • Phone: 407-645-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1717002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: