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General NPI Number Information
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NPI Number | 1336544733
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Entity Type | Individual
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Provider Name | MARIE ROSE SAMUELA JASMIN APRN
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1500 N UNIVERSITY DRIVE SUITE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071
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Country | US
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Telephone | 954-350-0747
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N UNIVERSITY DR STE 202
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6072
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Country | US
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Telephone | 954-350-0747
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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 | 9294753
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9294753
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License Number State | FL
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