=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174934830
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIE VOLINE DUCLAIR ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2014
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 PARK AVE
-----------------------------------------------------
City | LAKE PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33403-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-568-2739
-----------------------------------------------------
Fax | 949-703-7886
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 PARK AVE
-----------------------------------------------------
City | LAKE PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33403-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-568-2739
-----------------------------------------------------
Fax | 561-223-3687
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 3106482
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 3106482
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------