Provider Demographics
NPI:1134831993
Name:BRETON, DILCIA DEL CARMEN (FNP)
Entity type:Individual
Prefix:
First Name:DILCIA
Middle Name:DEL CARMEN
Last Name:BRETON
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 1:16377 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5115
Mailing Address - Country:US
Mailing Address - Phone:754-610-6934
Mailing Address - Fax:
Practice Address - Street 1:1700 NW 64TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1800
Practice Address - Country:US
Practice Address - Phone:954-202-5761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily