Individual
MR. MATTHEW L MAROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
(321) 434-1667
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN2941622
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN2941622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269581201
—
FL
01
—
Y050JT
FL MEDICARE
FL
01
—
Y050JU
HFPSI MEDICARE
FL
Enumeration date
11/18/2005
Last updated
03/20/2024
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