Provider Demographics
NPI:1790898500
Name:DY BUCO, LIGAYA A (NURSE PRACTIONER)
Entity Type:Individual
Prefix:MRS
First Name:LIGAYA
Middle Name:A
Last Name:DY BUCO
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:MRS
Other - First Name:LIGAYA
Other - Middle Name:
Other - Last Name:HEINZELMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1865 BRICKELL AVE
Mailing Address - Street 2:A1510
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129
Mailing Address - Country:US
Mailing Address - Phone:305-854-6008
Mailing Address - Fax:305-854-3105
Practice Address - Street 1:1201 NW 16TH ST
Practice Address - Street 2:DEPARTMENT OF VETERANS AFFAIR HEALTH SERVICES
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-575-7001
Practice Address - Fax:305-575-7002
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLERNP1282512363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health