Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9179015 | FL |
NPI | 1033429949 |
---|---|
Provider Name | Paulette Paul |
First Address | Pembroke Pines, FL 33028 |
Second Address | Pembroke Pines, FL 33028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2010 |
Last Update Date | 18/09/2013 |