1568499622 NPI number — MRS. ANN MARIE PATRICIA MARCH ARNP

Table of content: MRS. ANN MARIE PATRICIA MARCH ARNP (NPI 1568499622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568499622 NPI number — MRS. ANN MARIE PATRICIA MARCH ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARCH
Provider First Name:
ANN MARIE
Provider Middle Name:
PATRICIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1568499622
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 10TH AVE N
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33461-3141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-642-1008
Provider Business Mailing Address Fax Number:
561-802-3976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
941 SE 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE GLADE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33430-4353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-996-6156
Provider Business Practice Location Address Fax Number:
561-439-4185
Provider Enumeration Date:
06/26/2006

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: 363LF0000X , with the licence number:  1431612 , 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)

  • Identifier: 300764200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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