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Individual

ALLEN MARYASIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
413 E PALMETTO PARK RD APT 740, BOCA RATON, FL 33432-5190
(917) 968-3162
Mailing address
413 E PALMETTO PARK RD APT 740, BOCA RATON, FL 33432-5190
(917) 968-3162

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11030948
FL
363L00000X
Nurse Practitioner
11030948
FL
363LF0000X
Family Nurse Practitioner
Primary
11030948
FL

Other

Enumeration date
02/07/2024
Last updated
04/17/2026
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