Provider Demographics
NPI:1396293056
Name:MARZI, LELAH RUTH (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LELAH
Middle Name:RUTH
Last Name:MARZI
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 1:10229 NW 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8056
Mailing Address - Country:US
Mailing Address - Phone:561-914-2500
Mailing Address - Fax:
Practice Address - Street 1:10229 NW 13TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8056
Practice Address - Country:US
Practice Address - Phone:561-914-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3370532363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health