Provider Demographics
NPI:1558043265
Name:MAGANA, PHOEBE (APRN)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:MAGANA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7367 PANACHE WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6940
Mailing Address - Country:US
Mailing Address - Phone:561-931-7873
Mailing Address - Fax:
Practice Address - Street 1:7367 PANACHE WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6940
Practice Address - Country:US
Practice Address - Phone:561-931-7873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily