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General NPI Number Information
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NPI Number | 1265806368
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Entity Type | Organization
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Legal Business Name | MARIE NP SERVICES, LLC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 710 N SUN DR
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City | LAKE MARY
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State | FL
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Zip | 32746-2507
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Country | US
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Telephone | 407-844-6521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 665
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City | GOTHA
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State | FL
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Zip | 34734-0665
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Country | US
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Telephone | 407-844-6521
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | FRANCHESCA MARIE PEREZ
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Credential |
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Telephone | 407-844-6521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9264882
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License Number State | FL
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