Provider Demographics
NPI:1437420221
Name:MAURICE, EMMANIE ANTENOR (ARNP)
Entity Type:Individual
Prefix:
First Name:EMMANIE
Middle Name:ANTENOR
Last Name:MAURICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3132 NW 122ND TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3016
Mailing Address - Country:US
Mailing Address - Phone:954-748-9766
Mailing Address - Fax:954-748-9766
Practice Address - Street 1:3132 NW 122ND TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3016
Practice Address - Country:US
Practice Address - Phone:954-748-9766
Practice Address - Fax:954-414-8376
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1999662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily