Individual
MARIE M ANTOINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6455 NW FAVIAN CT, PORT ST LUCIE, FL 34986-4405
(772) 626-8026
(772) 873-4670
Mailing address
2114 SE BISBEE ST, PORT ST LUCIE, FL 34952-4918
(772) 626-8026
(772) 873-4670
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 2015392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685946196
—
FL
Enumeration date
06/25/2008
Last updated
06/25/2008
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