Basic Information
Provider Information
NPI: 1932711728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMILIEN
FirstName: MARLIE
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: MSN, CNM, APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 770 NORTHPOINT PKWY STE 102
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334071901
CountryCode: US
TelephoneNumber: 5618025357
FaxNumber:  
Practice Location
Address1: 770 NORTHPOINT PKWY STE 200
Address2:  
City: WEST PALM BEACH
State: FL
PostalCode: 334071901
CountryCode: US
TelephoneNumber: 5616553331
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/21/2020
LastUpdateDate: 03/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001X11007724FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
367A00000X11007724FLY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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