Provider Demographics
NPI:1124658109
Name:ARANZOLA, MARLENE
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:ARANZOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 VISTA MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1835
Mailing Address - Country:US
Mailing Address - Phone:305-407-4763
Mailing Address - Fax:954-541-5963
Practice Address - Street 1:761 VISTA MEADOWS DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-1835
Practice Address - Country:US
Practice Address - Phone:305-407-4763
Practice Address - Fax:954-541-5963
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5646246ZE0500X, 2472E0500X
FL373246ZE0600X
5646156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No156F00000XEye and Vision Services ProvidersTechnician/Technologist