Provider Demographics
NPI:1861658478
Name:MURIENTE, MARIA T (MD)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:T
Last Name:MURIENTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6675 WESTWOOD BLVD STE 475
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6027
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:888-972-1752
Practice Address - Street 1:111 WEBB DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3962
Practice Address - Country:US
Practice Address - Phone:863-421-9447
Practice Address - Fax:863-421-1806
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-03
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17187208D00000X
FLACN1433208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR17187OtherLICENCE