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General NPI Number Information
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NPI Number | 1417121633
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Entity Type | Individual
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Provider Name | LEROY ANSELM MARKLUND ARNP
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Gender | Male
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 7797 NW 114TH PATH
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City | MEDLEY
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State | FL
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Zip | 33178-1383
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Country | US
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Telephone | 305-807-0045
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 NW 10TH AVE US ATTC SUITE T-215
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City | MIAMI
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State | FL
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Zip | 33136-1018
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Country | US
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Telephone | 305-585-1852
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 16422
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 2685
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License Number State | CA
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