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Organization
DIVINE HEALTHCARE SERVICE CORP
Active
Organization
DIVINE HEALTHCARE SERVICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIE EDITH MALOKU ARNP (NP)
(954) 559-6045
Entity
Organization
Contact information
Practice address
15883 NW 11TH ST, PEMBROKE PINES, FL 33028
(954) 559-6045
(954) 450-7975
Mailing address
15883 NW 11TH ST, PEMBROKE PINES, FL 33028-1602
(954) 559-6045
(954) 450-7975
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1691672
FL
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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