Provider Demographics
NPI:1538051990
Name:BUCARITO, KATHLEEN PRISCILLA (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:PRISCILLA
Last Name:BUCARITO
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 NW 121ST DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3225
Mailing Address - Country:US
Mailing Address - Phone:954-479-4265
Mailing Address - Fax:
Practice Address - Street 1:15700 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2109
Practice Address - Country:US
Practice Address - Phone:786-434-5987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily