Provider Demographics
NPI:1407568561
Name:CRIBEIRO, SULAY LAZARA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SULAY
Middle Name:LAZARA
Last Name:CRIBEIRO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24071 SW 114TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3137
Mailing Address - Country:US
Mailing Address - Phone:786-510-0396
Mailing Address - Fax:
Practice Address - Street 1:24071 SW 114TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-3137
Practice Address - Country:US
Practice Address - Phone:786-510-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily