1427232842 NPI number — MS. MONICA PATRICIA MARINO SLPA

Table of content: MS. MONICA PATRICIA MARINO SLPA (NPI 1427232842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427232842 NPI number — MS. MONICA PATRICIA MARINO SLPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARINO
Provider First Name:
MONICA
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SLPA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427232842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4001 BENEVA RD APT 324
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SARASOTA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34233-1052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-400-4457
Provider Business Mailing Address Fax Number:
941-923-1193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2415 UNIVERSITY PARKWAY BULDING #3
Provider Second Line Business Practice Location Address:
SUIT # 218
Provider Business Practice Location Address City Name:
SARASOTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-359-9555
Provider Business Practice Location Address Fax Number:
941-359-1555
Provider Enumeration Date:
12/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2355S0801X , with the licence number:  SI 1478 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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