Provider Demographics
NPI:1689030900
Name:BAUZA, IZAELA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:IZAELA
Middle Name:
Last Name:BAUZA
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 1:8750 NW 36TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2499
Mailing Address - Country:US
Mailing Address - Phone:305-262-1610
Mailing Address - Fax:
Practice Address - Street 1:900 W 49TH ST STE 308
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3435
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:305-558-9039
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9292541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019056500Medicaid
FLARNP9292541OtherADVANCED REGISTERED NURSE PRACTITIONER