MEDICARE: ANGELICA MARIA PAULSEN FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95011219	CA
2	363LF0000X	Family Nurse Practitioner	APRN11027686	FL

General Provider Information

NPI Number	:	1790243657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA MARIA PAULSEN FNP-BC

Provider Business Mailing Address
First Line	:	325 S BISCAYNE BLVD APT 923
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2307
Country	:	US
Telephone Number	:	305-815-0036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3661 S MIAMI AVE STE 606
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4248
Country	:	US
Telephone Number	:	305-701-7168
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2019
Last Update Date	:	08/23/2024

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