Provider Demographics
NPI:1700599149
Name:BOONE, MARIA (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 SE 57TH DR
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-1752
Mailing Address - Country:US
Mailing Address - Phone:863-447-7378
Mailing Address - Fax:
Practice Address - Street 1:1796 HWY 441 NORTH
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974
Practice Address - Country:US
Practice Address - Phone:863-763-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024167363LF0000X
FLRN9460918163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency