Provider Demographics
NPI:1801102751
Name:PARE, PHYLLIS DENISE (ARNP)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:DENISE
Last Name:PARE
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 1:600 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1609
Mailing Address - Country:US
Mailing Address - Phone:866-448-7716
Mailing Address - Fax:954-596-4746
Practice Address - Street 1:600 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1609
Practice Address - Country:US
Practice Address - Phone:866-448-7716
Practice Address - Fax:954-596-4746
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2018452363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner