Provider Demographics
NPI:1558722751
Name:ANDREICA, ANCUTA OFELIA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:ANCUTA
Middle Name:OFELIA
Last Name:ANDREICA
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6000 GLADES RD
Mailing Address - Street 2:STE 1055-B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7208
Mailing Address - Country:US
Mailing Address - Phone:561-509-5394
Mailing Address - Fax:
Practice Address - Street 1:6000 GLADES RD
Practice Address - Street 2:STE 1055-B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7208
Practice Address - Country:US
Practice Address - Phone:561-509-5394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109313363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant