Individual
MARIEL ALTAGRACIA SUSANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
944 S MILITARY TRL, WEST PALM BEACH, FL 33415-3910
(561) 425-8000
Mailing address
10440 NW 74TH ST UNIT 305, MEDLEY, FL 33178-2462
(347) 853-6393
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
11007448
FL
363LA2200X
Adult Health Nurse Practitioner
APRN11007448
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11007448
FL
Other
Enumeration date
07/14/2020
Last updated
08/01/2023
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