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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARISSA BOURNIQUE

Active Sole Proprietor

MARISSA BOURNIQUE is a Gastroenterology healthcare provider located in PORT ST LUCIE, Florida. NPI 1417332131 is currently active in the NPPES registry. Verify at CMS.

Gastroenterology · PORT ST LUCIE, FL

Registration Details

NPI Number
1417332131
Provider Type
Individual
Gender
Female
NPI Issued
Jul 23, 2015 (11.088468433152 yrs)
Last Updated
Apr 8, 2021
Licenses
UO4447 (FL)
OS15441 (FL)
Sole Proprietor
Yes

Practice Information

Address
1700 SE HILLMOOR DR
PORT ST LUCIE, FL, 349527539
Browse FL providers · Browse ZIP 34952
Phone
7723359600
Primary Specialty
Gastroenterology
207RG0100X
Additional Specialty
Gastroenterology

Other Gastroenterology Providers in PORT ST LUCIE, FL

Name Credential NPI
JOHN COURTNEY KAUFMAN M.D. 1841283546
STEVEN M KAPPLER M.D. 1265490163
DR. JAYSHREE MATADIAL MD 1568416030
DR. KENNETH R KOHEN M.D. 1912940479
EDWIN BENEDICT FLANAGAN D.O. 1043239866
CELSO E PINEIRO M.D. 1053325118
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.