MEDICARE: MARJORIE PARAISON-DORELIEN

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	11014194	FL

General Provider Information

NPI Number	:	1457024986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE PARAISON-DORELIEN

Provider Business Mailing Address
First Line	:	PO BOX 8255
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33075-8255
Country	:	US
Telephone Number	:	305-720-3815
Fax Number	:

Provider Business Practice Location Address
First Line	:	8280 SW 24TH ST APT 211
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-5189
Country	:	US
Telephone Number	:	305-720-3815
Fax Number	:

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

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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