Kooima, Marisa Jo

Kooima, Marisa Jo is an individual health care provider with primary practice located at 200 S Birch Rd Apt 1209 , Ft Lauderdale FL 33316-1537. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kooima, Marisa Jo can be contacted via phone (954) 629-2240.

Contact Information

Primary practice address
200 S Birch Rd Apt 1209 Ft Lauderdale FL 33316-1537
Phone: (954) 629-2240
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP 9246107 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN9246107 Florida

Profile Details

NPI number 1316240674
LBN Legal business name Kooima, Marisa Jo
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2010
Last updated Sep 17th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316240674 NPPES
Florida Other 592202 WELLCARE
Florida Other P988384 WELLCARE
Florida Other Y06HO WELLCARE
Florida Other P932403 WELLCARE
Florida MEDICAID 003103900 WELLCARE
Florida Other Y06H0 WELLCARE

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