Provider Demographics
NPI:1932063963
Name:PAUL, VERLANDA (PA)
Entity type:Individual
Prefix:
First Name:VERLANDA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12224 HIGH ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2333
Mailing Address - Country:US
Mailing Address - Phone:941-592-1982
Mailing Address - Fax:
Practice Address - Street 1:12224 HIGH ROCK WAY
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2333
Practice Address - Country:US
Practice Address - Phone:941-592-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-15
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002704-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant