Provider Demographics
NPI:1962954222
Name:SANTAMARINA, MARISOL ISABEL (ARNP)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:ISABEL
Last Name:SANTAMARINA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4524
Mailing Address - Country:US
Mailing Address - Phone:352-375-1212
Mailing Address - Fax:352-416-0818
Practice Address - Street 1:3239 NW YORK DR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-8641
Practice Address - Country:US
Practice Address - Phone:386-752-0515
Practice Address - Fax:386-752-3815
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9264170363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care