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General NPI Number Information
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NPI Number | 1194440008
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Entity Type | Individual
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Provider Name | ODALIS MARRERO DNP,APRN,FNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 760 PONCE DE LEON BLVD STE 100
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City | CORAL GABLES
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State | FL
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Zip | 33134-2076
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Country | US
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Telephone | 305-883-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 4161 W 2ND AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4421
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Country | US
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Telephone | 305-300-5338
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11014823
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License Number State | FL
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