Provider Demographics
NPI:1821513243
Name:MURAT, MARIE EVENS
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:EVENS
Last Name:MURAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11573 MISTY ISLE LANE
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579
Mailing Address - Country:US
Mailing Address - Phone:813-495-3064
Mailing Address - Fax:
Practice Address - Street 1:12718 LOVERS LANE
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579
Practice Address - Country:US
Practice Address - Phone:813-495-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9190703163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692083796Medicaid