Provider Demographics
NPI:1194198515
Name:AMEDE, MARIE MICHELLE
Entity Type:Individual
Prefix:
First Name:MARIE MICHELLE
Middle Name:
Last Name:AMEDE
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 1:2719 TARPON DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-4524
Mailing Address - Country:US
Mailing Address - Phone:786-488-8548
Mailing Address - Fax:
Practice Address - Street 1:1599 SW 187TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33194-2801
Practice Address - Country:US
Practice Address - Phone:305-228-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9284604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily