Provider Demographics
NPI:1215355540
Name:ALIZA, MARIE C
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:C
Last Name:ALIZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:C
Other - Last Name:ALIZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:6901 OKEECHOBEE BLVD STE C12
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2512
Mailing Address - Country:US
Mailing Address - Phone:561-469-7005
Mailing Address - Fax:561-584-7208
Practice Address - Street 1:6901 OKEECHOBEE BLVD STE C12
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2512
Practice Address - Country:US
Practice Address - Phone:561-469-7005
Practice Address - Fax:561-584-7208
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9244322363LF0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily