=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346478864
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA KHRISTINE TECSON RN, ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2009
-----------------------------------------------------
Last Update Date | 10/09/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 45TH ST
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33407-2413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-882-2913
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20831 SAN SIMEON WAY APT 204
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-1843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-467-1405
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0222X
-----------------------------------------------------
Taxonomy Name | Critical Care Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9220275
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Registered Nurse
-----------------------------------------------------
License Number | RN9220275
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------