Provider Demographics
NPI:1578287918
Name:POO CANGAS, ADA ESTHER (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ADA
Middle Name:ESTHER
Last Name:POO CANGAS
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 1:421 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4442
Mailing Address - Country:US
Mailing Address - Phone:561-275-1155
Mailing Address - Fax:561-275-1156
Practice Address - Street 1:421 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-4442
Practice Address - Country:US
Practice Address - Phone:561-275-1155
Practice Address - Fax:561-275-1156
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily