Individual
MARLENA DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
703 VIRGINIA ST, DUNEDIN, FL 34698-6615
(727) 734-4000
Mailing address
703 VIRGINIA ST, DUNEDIN, FL 34698-6615
(727) 734-4000
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
9304586
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016378300
—
FL
Enumeration date
10/16/2015
Last updated
03/16/2016
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