Provider Demographics
NPI:1255363909
Name:WENDER, MARILYNN FAITH (ARNP/CNM)
Entity type:Individual
Prefix:MRS
First Name:MARILYNN
Middle Name:FAITH
Last Name:WENDER
Suffix:
Gender:F
Credentials:ARNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4616
Mailing Address - Country:US
Mailing Address - Phone:561-274-3100
Mailing Address - Fax:561-837-5332
Practice Address - Street 1:225 SOUTH CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-274-3100
Practice Address - Fax:561-274-3144
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP919002363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304657500Medicaid
FL919002OtherARNP/CNM LICENSEE
FLS28373Medicare UPIN
FLY2876YMedicare ID - Type Unspecified