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General NPI Number Information
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NPI Number | 1437866118
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Entity Type | Individual
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Provider Name | ANISE MARC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 7225 MAIDA LN APT 8I
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City | FORT MYERS
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State | FL
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Zip | 33908-4223
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Country | US
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Telephone | 239-601-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 813-575-1161
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 77100
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License Number State | FL
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