Provider Demographics
NPI:1396543609
Name:WITHROW, MARIE CHRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CHRISTINE
Last Name:WITHROW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 76TH DR STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6663
Mailing Address - Country:US
Mailing Address - Phone:352-332-4151
Mailing Address - Fax:352-332-2966
Practice Address - Street 1:350 NW 76TH DR STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6663
Practice Address - Country:US
Practice Address - Phone:352-332-4151
Practice Address - Fax:352-332-2966
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119950363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical