Provider Demographics
NPI:1205226040
Name:PURPERA, PAULA ANTONIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANTONIA
Last Name:PURPERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 NE 69TH ST
Mailing Address - Street 2:APT11S
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-5760
Mailing Address - Country:US
Mailing Address - Phone:440-570-0725
Mailing Address - Fax:
Practice Address - Street 1:880 NE 69TH ST
Practice Address - Street 2:APT11S
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-5760
Practice Address - Country:US
Practice Address - Phone:440-570-0725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9108591363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant