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General NPI Number Information
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NPI Number | 1972996072
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Entity Type | Organization
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Legal Business Name | ELYSE MARRONE, RD PLLC
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 1306 SONOMA CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-1517
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Country | US
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Telephone | 561-252-7857
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Fax | 860-760-6026
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Provider Business Mailing Address
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Address Line | 1306 SONOMA CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-1517
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Country | US
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Telephone | 561-252-7857
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Fax | 860-760-6026
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ELYSE K MARRONE
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Credential | RD
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Telephone | 561-252-7857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | ND6053
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License Number State | FL
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