Provider Demographics
NPI:1639054703
Name:SPENCE-RESIERE, MARIE ANTONETTE
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:ANTONETTE
Last Name:SPENCE-RESIERE
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 1:8950 N KENDALL DR STE 600W
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2139
Mailing Address - Country:US
Mailing Address - Phone:786-596-1230
Mailing Address - Fax:
Practice Address - Street 1:8950 N KENDALL DR STE 600W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2139
Practice Address - Country:US
Practice Address - Phone:786-596-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily