Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 11003628 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN11003628 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 11003628 | FL |
NPI | 1003465527 |
---|---|
Provider Name | Elizabeth Bauza |
First Address | Hialeah, FL 33014-3943 |
Second Address | Hialeah, FL 33014-3943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2019 |
Last Update Date | 06/09/2019 |