Individual
MARIELLE AMELI AMOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, NEMOURS CHILDRENS SPECIALTY CARE, JACKSONVILLE, JACKSONVILLE, FL 32207-8426
(904) 697-3600
(904) 697-3927
Mailing address
10140 CENTURION PKWY N, PROVIDER ENROLLMENT, JACKSONVILLE, FL 32256-0532
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
TRN14929
FL
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME126475
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018556000
—
FL
Enumeration date
05/17/2010
Last updated
01/03/2018
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