Provider Demographics
NPI:1700321619
Name:CAICEDO, LUCY MARGARITA (ARNP)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:MARGARITA
Last Name:CAICEDO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 79TH STREET CSWY STE 120
Mailing Address - Street 2:
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4197
Mailing Address - Country:US
Mailing Address - Phone:786-406-2144
Mailing Address - Fax:
Practice Address - Street 1:1700 79TH STREET CSWY STE 120
Practice Address - Street 2:
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-4197
Practice Address - Country:US
Practice Address - Phone:305-726-2177
Practice Address - Fax:305-726-2209
Is Sole Proprietor?:No
Enumeration Date:2017-01-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9356924363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily