Provider Demographics
NPI:1376048116
Name:MASIGLA, MARIKIT PASAMBA (APRN)
Entity Type:Individual
Prefix:
First Name:MARIKIT
Middle Name:PASAMBA
Last Name:MASIGLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 SUN N LAKE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4240 SUN N LAKE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872
Practice Address - Country:US
Practice Address - Phone:863-471-3926
Practice Address - Fax:863-385-3093
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9304579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily