Provider Demographics
NPI:1013443159
Name:REMY, MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:REMY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 SE WALTON RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7168
Mailing Address - Country:US
Mailing Address - Phone:772-335-0400
Mailing Address - Fax:
Practice Address - Street 1:1362 SW BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2929
Practice Address - Country:US
Practice Address - Phone:772-873-5213
Practice Address - Fax:772-873-5215
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205797363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily