Provider Demographics
NPI:1063383529
Name:DEPAL, MARIE CARMELLE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CARMELLE
Last Name:DEPAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:VITAL
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 NW 214TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2160
Mailing Address - Country:US
Mailing Address - Phone:786-399-0831
Mailing Address - Fax:
Practice Address - Street 1:510 NW 214TH ST APT 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2160
Practice Address - Country:US
Practice Address - Phone:786-399-0831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5267325164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse