Provider Demographics
NPI:1497527865
Name:DEL CID, MARYANN
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:DEL CID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 US HIGHWAY 1 S # 111
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6076
Mailing Address - Country:US
Mailing Address - Phone:661-210-9782
Mailing Address - Fax:
Practice Address - Street 1:1400 OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4190
Practice Address - Country:US
Practice Address - Phone:904-829-2273
Practice Address - Fax:904-824-0724
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028932363LP0808X
FL11028932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health