Provider Demographics
NPI:1679562490
Name:FOCARACCI, TERESA A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:A
Last Name:FOCARACCI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:A
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2141 NE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7622
Mailing Address - Country:US
Mailing Address - Phone:954-781-5930
Mailing Address - Fax:954-337-0602
Practice Address - Street 1:850 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7010
Practice Address - Country:US
Practice Address - Phone:954-345-4333
Practice Address - Fax:954-345-4334
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1560012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P88526Medicare UPIN
FLU06062Medicare ID - Type Unspecified