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General NPI Number Information
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NPI Number | 1124413323
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Entity Type | Individual
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Provider Name | MARINA NIKOLAYEVNA PODOLSKIY ARNP/ CNM
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Gender | Female
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 3410 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8112
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Country | US
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Telephone | 941-251-8477
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Fax |
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Provider Business Mailing Address
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Address Line | 2439 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34239-6304
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Country | US
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Telephone | 941-222-2146
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Fax | 941-378-9120
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 2020026950
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP60863109
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRN11032140
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License Number State | FL
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