Provider Demographics
NPI:1104198993
Name:FELIX LUCIUS, MARIE L (RN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:L
Last Name:FELIX LUCIUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20621 WHITEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3216
Mailing Address - Country:US
Mailing Address - Phone:786-326-5694
Mailing Address - Fax:
Practice Address - Street 1:20621 WHITEWOOD WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3216
Practice Address - Country:US
Practice Address - Phone:813-973-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9321313163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse