Provider Demographics
NPI:1427552850
Name:ALCAZAR, BOBBIE JO (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE JO
Middle Name:
Last Name:ALCAZAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 NE 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-8273
Mailing Address - Country:US
Mailing Address - Phone:863-801-4478
Mailing Address - Fax:
Practice Address - Street 1:4511 SUN N LAKE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872
Practice Address - Country:US
Practice Address - Phone:863-385-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9370124163WC0200X
FLARNP9370124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine