Provider Demographics
NPI:1558910141
Name:NEARLA INTEGRATED HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:NEARLA INTEGRATED HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:MARLENE
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:561-358-9151
Mailing Address - Street 1:16404 VALENCIA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-2705
Mailing Address - Country:US
Mailing Address - Phone:561-358-9151
Mailing Address - Fax:
Practice Address - Street 1:2401 PGA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3515
Practice Address - Country:US
Practice Address - Phone:561-316-8202
Practice Address - Fax:561-461-6203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1346630092OtherNPI