Provider Demographics
NPI:1295877736
Name:FLEURIMOND, MARIE MAUDE (ARNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:MAUDE
Last Name:FLEURIMOND
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 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:407-906-0082
Mailing Address - Fax:407-604-2606
Practice Address - Street 1:2724 N HIAWASSEE RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3008
Practice Address - Country:US
Practice Address - Phone:407-906-0082
Practice Address - Fax:407-604-2606
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2619062363LF0000X
FLARNP2619062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021328600Medicaid
FLY07L7OtherBCBS