Provider Demographics
NPI:1801336383
Name:VELASQUEZ-SEDITO, MARLENE MARIA (ARNP)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:MARIA
Last Name:VELASQUEZ-SEDITO
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 1:20 CELESTIAL WAY
Mailing Address - Street 2:APT. #308
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2372
Mailing Address - Country:US
Mailing Address - Phone:305-776-7076
Mailing Address - Fax:
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:SUITE #211
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2791
Practice Address - Country:US
Practice Address - Phone:561-253-8121
Practice Address - Fax:561-253-8021
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1647662363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health