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General NPI Number Information
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NPI Number | 1477535144
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Entity Type | Individual
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Provider Name | MARIANNETTE PLAZA NP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 127 RIDGE CENTER DR
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City | DAVENPORT
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State | FL
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Zip | 33837-6401
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Country | US
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Telephone | 863-421-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 S DOUGLAS RD STE 308
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City | CORAL GABLES
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State | FL
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Zip | 33134-6134
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Country | US
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Telephone | 305-913-9454
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Fax | 305-442-1198
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9408302
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License Number State | FL
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