Provider Demographics
NPI:1245839612
Name:EXANTUS, RANCHA (APRN)
Entity type:Individual
Prefix:
First Name:RANCHA
Middle Name:
Last Name:EXANTUS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 E OCEAN AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-5017
Mailing Address - Country:US
Mailing Address - Phone:561-735-6553
Mailing Address - Fax:561-735-7739
Practice Address - Street 1:709 S FEDERAL HWY STE 3
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-5610
Practice Address - Country:US
Practice Address - Phone:561-735-6553
Practice Address - Fax:561-735-7739
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009744363L00000X
FLAPRN11009744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner