Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 0010567 | FL |
NPI | 1063549871 |
---|---|
Provider Name | Dr. Valerie Ann Marino |
First Address | North Palm Beach, FL 33408-3537 |
Second Address | North Palm Beach, FL 33408-3537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |