Individual
MARVEL LUCRETIA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 NW 34TH AVE, FORT LAUDERDALE, FL 33309-1225
(954) 494-7564
Mailing address
6600 NW 34TH AVE, FORT LAUDERDALE, FL 33309-1225
(954) 494-7564
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11008524
FL
Other
Enumeration date
07/23/2020
Last updated
08/08/2020
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