Provider Demographics
NPI:1023838968
Name:DE FARIA, ANA PAULA (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANA PAULA
Middle Name:
Last Name:DE FARIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 BANYAN BOULEVARD CIR NW
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6363
Mailing Address - Country:US
Mailing Address - Phone:754-207-2400
Mailing Address - Fax:
Practice Address - Street 1:15805 BISCAYNE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-5378
Practice Address - Country:US
Practice Address - Phone:786-360-6315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily