Provider Demographics
NPI:1649080433
Name:DAREDIYA, NAUHA AZIZ (PA-C)
Entity type:Individual
Prefix:
First Name:NAUHA
Middle Name:AZIZ
Last Name:DAREDIYA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NAUHA
Other - Middle Name:AZIZ
Other - Last Name:DAREDIYA ELKHOULY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:9050 EQUUS CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4314
Mailing Address - Country:US
Mailing Address - Phone:954-400-9855
Mailing Address - Fax:
Practice Address - Street 1:9050 EQUUS CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-4314
Practice Address - Country:US
Practice Address - Phone:954-400-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant