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Organization
MLACSON RNFA SERVICES INC.
Active
Organization
MLACSON RNFA SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILENE GOPEZ LACSON ARNP (OWNER/ADMINSITRATOR)
(386) 503-9731
Entity
Organization
Contact information
Practice address
38 ROLLER LN, PALM COAST, FL 32164-8939
(386) 503-9731
Mailing address
PO BOX 350031, PALM COAST, FL 32135-0031
(386) 503-9731
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP 9270072
FL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
ARNP 9270072
FL
Other
Enumeration date
04/05/2013
Last updated
03/14/2015
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