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NPI Code Detail

MEDICARE: MARIFRANCES CHRISTINE GULLO ARNP

MEDICARE: MARIFRANCES CHRISTINE GULLO ARNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerARNP 2530742FL
2363LF0000XFamily Nurse PractitionerARNP2530742FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112263601OTHERFLCAQH

General Provider Information

NPI Number : 1942339346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIFRANCES CHRISTINE GULLO ARNP
Provider Business Mailing Address
First Line : 565 MEMORIAL CIR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5001
Country : US
Telephone Number : 386-310-8766
Fax Number : 386-310-8770
Provider Business Practice Location Address
First Line : 565 MEMORIAL CIR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5001
Country : US
Telephone Number : 386-310-8766
Fax Number : 386-310-8770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 11/09/2015

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