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General NPI Number Information
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NPI Number | 1023923133
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Entity Type | Individual
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Provider Name | MARINA BRUCKNER APRN
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Gender | Female
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 6834 PARKSIDE DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-2914
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Country | US
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Telephone | 727-267-6993
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Fax |
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Provider Business Mailing Address
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Address Line | 6834 PARKSIDE DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-2914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11048967
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License Number State | FL
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