Provider Demographics
NPI:1922721232
Name:AMIN, TULSI (AGACNP)
Entity Type:Individual
Prefix:
First Name:TULSI
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10628 WHEELHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1216
Mailing Address - Country:US
Mailing Address - Phone:704-737-4391
Mailing Address - Fax:
Practice Address - Street 1:5341 ATLANTIC AVE STE 301
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8166
Practice Address - Country:US
Practice Address - Phone:561-450-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021782363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner