Provider Demographics
NPI:1730432899
Name:GIRLIE, MARCELLINE L (DNP, ARNP-BC)
Entity type:Individual
Prefix:DR
First Name:MARCELLINE
Middle Name:L
Last Name:GIRLIE
Suffix:
Gender:F
Credentials:DNP, ARNP-BC
Other - Prefix:DR
Other - First Name:MARCELLINE
Other - Middle Name:
Other - Last Name:LAZARRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, ARNP-BC
Mailing Address - Street 1:2222 OCOEE APOPKA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-5344
Mailing Address - Country:US
Mailing Address - Phone:239-357-1945
Mailing Address - Fax:
Practice Address - Street 1:2222 OCOEE APOPKA RD STE 106
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-5344
Practice Address - Country:US
Practice Address - Phone:407-698-5092
Practice Address - Fax:407-550-3790
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9350985363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008955600Medicaid