Basic Information
Provider Information
NPI: 1861758419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARCH
FirstName: DANA
MiddleName: ELISE
NamePrefix: MS.
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1117 E HALLANDALE BEACH BLVD
Address2:  
City: HALLANDALE BEACH
State: FL
PostalCode: 330094488
CountryCode: US
TelephoneNumber: 9544545131
FaxNumber: 9542416908
Practice Location
Address1: 3501 JOHNSON ST
Address2:  
City: HOLLYWOOD
State: FL
PostalCode: 330215421
CountryCode: US
TelephoneNumber: 9542656301
FaxNumber: 9549851434
Other Information
ProviderEnumerationDate: 04/09/2012
LastUpdateDate: 01/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X309005559ILN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LP0222XARNP9426537FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care

No ID Information.


Home