Provider Demographics
NPI:1265953756
Name:BUELA, NEDELIS C (ARNP, AGNP)
Entity type:Individual
Prefix:
First Name:NEDELIS
Middle Name:C
Last Name:BUELA
Suffix:
Gender:F
Credentials:ARNP, AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8741 NW 145TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-8017
Mailing Address - Country:US
Mailing Address - Phone:786-443-4767
Mailing Address - Fax:
Practice Address - Street 1:2601 DAVIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-3029
Practice Address - Country:US
Practice Address - Phone:754-216-2458
Practice Address - Fax:954-734-6750
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAG05170038363LA2200X, 363LG0600X
FL9291427363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology