Organization Name: | RICHARD MARINO ARNP INC |
NPI Number: | 1518908813 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD MICHAEL MARINO (PRESIDENT) |
Mailing Address: | 401 Melbourne Ave Indialantic |
State: | FL US |
Postal Code: | 329034317 |
Phone Number: | 3217287651 |
Fax Number: | 3219525643 |
NPI Enumeration Date: | 06/09/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP 1218162 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |