MEDICARE: MARIE PHILOGENE

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	251E00000X	Home Health Agency		FL
2	172V00000X	Community Health Worker		FL
3	374U00000X	Home Health Aide	CNA54575	FL

General Provider Information

NPI Number	:	1083594253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE PHILOGENE

Provider Business Mailing Address
First Line	:	4763 NW 117TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2248
Country	:	US
Telephone Number	:	877-771-2128
Fax Number	:	877-771-2128

Provider Business Practice Location Address
First Line	:	4763 NW 117TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2248
Country	:	US
Telephone Number	:	877-771-2128
Fax Number	:	877-771-2128

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

Provider Enumeration Date	:	09/06/2025
Last Update Date	:	09/06/2025

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Directions to “ MARIE PHILOGENE ” Practice Location

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