Provider Demographics
NPI:1104305697
Name:PYRAM, MARIE LUCIE (CRT)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:LUCIE
Last Name:PYRAM
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 NE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3215
Mailing Address - Country:US
Mailing Address - Phone:954-547-7180
Mailing Address - Fax:
Practice Address - Street 1:4801 NE 8TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-547-7180
Practice Address - Fax:954-533-9367
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL102752278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care