Individual
MARISA COULURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612
(813) 259-8700
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
OS9261
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270226600
—
FL
01
—
48177
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
03/13/2025
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