Provider Demographics
NPI:1881478543
Name:FLEITES RUMBAUT, MARILYN (APRN)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:FLEITES RUMBAUT
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 1:7001 SW 97TH AVE STE 101A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1407
Mailing Address - Country:US
Mailing Address - Phone:305-273-7998
Mailing Address - Fax:
Practice Address - Street 1:7001 SW 97TH AVE STE 101A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1407
Practice Address - Country:US
Practice Address - Phone:305-273-7998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily