Provider Demographics
NPI:1558606947
Name:DALPAN, MARISA GIULIANA (AP)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:GIULIANA
Last Name:DALPAN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 EDGEWATER DR
Mailing Address - Street 2:SUITE 602
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6942
Mailing Address - Country:US
Mailing Address - Phone:917-208-2506
Mailing Address - Fax:
Practice Address - Street 1:2355 SALZEDO ST
Practice Address - Street 2:SUITE 303
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5001
Practice Address - Country:US
Practice Address - Phone:917-208-2506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2071171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist