Provider Demographics
NPI:1790243657
Name:PAULSEN, ANGELICA MARIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:MARIA
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:MARIA
Other - Last Name:PAULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:325 S BISCAYNE BLVD APT 923
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2307
Mailing Address - Country:US
Mailing Address - Phone:305-815-0036
Mailing Address - Fax:
Practice Address - Street 1:3661 S MIAMI AVE STE 606
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4248
Practice Address - Country:US
Practice Address - Phone:305-701-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011219363LF0000X
FLAPRN11027686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily