Provider Demographics
NPI:1467739839
Name:BOHORQUEZ, CECILIA (AP)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:
Last Name:BOHORQUEZ
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7420
Mailing Address - Country:US
Mailing Address - Phone:954-663-5094
Mailing Address - Fax:
Practice Address - Street 1:8771 STIRLING RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-5932
Practice Address - Country:US
Practice Address - Phone:954-603-1311
Practice Address - Fax:954-252-5199
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-13
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1971171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP 1971OtherDEPARTMENT OF HEALTH. DIVISION OF MEDICAL QUALITY ASSURANCE