Provider Demographics
NPI:1134507577
Name:VINCENT, MARIE LUCIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LUCIE
Last Name:VINCENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 LAKE WORTH RD STE 135
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2474
Mailing Address - Country:US
Mailing Address - Phone:561-860-1463
Mailing Address - Fax:561-839-1535
Practice Address - Street 1:8461 LAKE WORTH RD STE 135
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2474
Practice Address - Country:US
Practice Address - Phone:561-860-1463
Practice Address - Fax:561-839-1535
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other