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General NPI Number Information
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NPI Number | 1740798891
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Entity Type | Individual
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Provider Name | MARIETTE DORCELUS II ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 13874 TANGERINE BLVD
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City | WEST PALM BCH
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State | FL
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Zip | 33412-1929
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Country | US
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Telephone | 254-462-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 11987 SOUTHERN BLVD # 1108
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7619
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Country | US
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Telephone | 561-270-9620
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9361053
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 9361053
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License Number State | FL
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