MEDICARE: MS. MARY ANN G MARKS ARNP MS

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	363L00000X	Nurse Practitioner	452052	FL

General Provider Information

NPI Number	:	1811195332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY ANN G MARKS ARNP MS

Provider Business Mailing Address
First Line	:	PO BOX 2394
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32961-2394
Country	:	US
Telephone Number	:	305-849-2586
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 57TH CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32966-4643
Country	:	US
Telephone Number	:	305-849-2586
Fax Number	:

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

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	07/08/2007

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