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General NPI Number Information
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NPI Number | 1558910141
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Entity Type | Organization
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Legal Business Name | NEARLA INTEGRATED HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 2401 PGA BLVD STE 130
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3515
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Country | US
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Telephone | 561-316-8202
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Fax | 561-461-6203
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Provider Business Mailing Address
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Address Line | 16404 VALENCIA BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-2705
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Country | US
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Telephone | 561-358-9151
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MARIE MARLENE JEAN
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Credential | FNP
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Telephone | 561-358-9151
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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 |
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License Number State |
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