Individual
MARISSA EARLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 S ORANGE AVE, ORLANDO, FL 32801-3383
(407) 930-9551
(407) 871-9240
Mailing address
5510 RAINTREE TRL, FORT PIERCE, FL 34982-3821
(619) 997-6053
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9774719
CA
172V00000X
Community Health Worker
9774719
FL
174400000X
Specialist
9774719
FL
363L00000X
Nurse Practitioner
FB9774719
FL
363LF0000X
Family Nurse Practitioner
FB9774719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114301
DEPARTMENT OF CONSUMER AFFAIRS
CA
01
—
9439937
FBN
FL
01
—
9774719
DPBR
FL
Enumeration date
04/06/2022
Last updated
07/08/2022
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