Provider Demographics
NPI:1902418171
Name:PREZZEMOLO, MARISSA (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:
Last Name:PREZZEMOLO
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 NW 33RD ST STE 116
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4000
Mailing Address - Country:US
Mailing Address - Phone:954-341-5034
Mailing Address - Fax:954-341-9190
Practice Address - Street 1:9750 NW 33RD ST STE 116
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4000
Practice Address - Country:US
Practice Address - Phone:954-341-5034
Practice Address - Fax:954-341-9190
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily