Provider Demographics
NPI:1780395350
Name:BOZA ANDRACA, DULCE M (ARNP)
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:M
Last Name:BOZA ANDRACA
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 1:1341 SW 124TH CT APT A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2344
Mailing Address - Country:US
Mailing Address - Phone:786-307-8209
Mailing Address - Fax:
Practice Address - Street 1:1341 SW 124TH CT APT A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2344
Practice Address - Country:US
Practice Address - Phone:786-307-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023163363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner