Provider Demographics
NPI:1790270189
Name:BOCA RATON FIRST ASSIST, PLLC
Entity Type:Organization
Organization Name:BOCA RATON FIRST ASSIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KULIK
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:407-702-5798
Mailing Address - Street 1:19885 GOLDEN BRIDGE TRAIL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498
Mailing Address - Country:US
Mailing Address - Phone:407-702-5798
Mailing Address - Fax:877-900-5188
Practice Address - Street 1:19885 GOLDEN BRIDGE TRAIL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498
Practice Address - Country:US
Practice Address - Phone:407-702-5798
Practice Address - Fax:877-900-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty