Provider Demographics
NPI:1801800636
Name:HALABY, PAULA FADWAH (ARNP, CNM)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:FADWAH
Last Name:HALABY
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-4844
Mailing Address - Country:US
Mailing Address - Phone:561-705-1022
Mailing Address - Fax:561-892-3355
Practice Address - Street 1:332 W BOYNTON BEACH BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-705-1022
Practice Address - Fax:561-892-3355
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247125363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308054400Medicaid
FLAD384ZMedicare PIN