MEDICARE: MARISSA FEO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11030804	FL

General Provider Information

NPI Number	:	1003678293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA FEO APRN

Provider Business Mailing Address
First Line	:	PO BOX 850001, DEPT 8340
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32885-0001
Country	:	US
Telephone Number	:	813-536-7277
Fax Number	:	855-830-1722

Provider Business Practice Location Address
First Line	:	1800 N FEDERAL HWY STE 104
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1011
Country	:	US
Telephone Number	:	954-782-0010
Fax Number	:	954-781-2139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	06/01/2026

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Directions to “ MARISSA FEO APRN” Practice Location

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