Provider Demographics
NPI:1295784858
Name:MARIE DARGENSON ARNP INC
Entity type:Organization
Organization Name:MARIE DARGENSON ARNP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-965-3696
Mailing Address - Street 1:1301 NE 200TH TER
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5139
Mailing Address - Country:US
Mailing Address - Phone:305-965-3696
Mailing Address - Fax:305-949-9463
Practice Address - Street 1:1301 NE 200TH TER
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5139
Practice Address - Country:US
Practice Address - Phone:305-965-3696
Practice Address - Fax:305-949-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1828592363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7591YMedicare ID - Type Unspecified