Provider Demographics
NPI:1235688458
Name:EBOKA, BEATRICE (FNP)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:EBOKA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1609
Mailing Address - Country:US
Mailing Address - Phone:954-246-1531
Mailing Address - Fax:
Practice Address - Street 1:600 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 1101
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1609
Practice Address - Country:US
Practice Address - Phone:954-246-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily