Provider Demographics
NPI:1477322915
Name:BORGES, KRISHNA UCHOA
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:UCHOA
Last Name:BORGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 LOCK RD APT 99436
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1889
Mailing Address - Country:US
Mailing Address - Phone:954-994-4608
Mailing Address - Fax:
Practice Address - Street 1:3402 N ANDREWS AVENUE EXT
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2067
Practice Address - Country:US
Practice Address - Phone:954-368-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1103017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily