Healthcare Provider Details

I. General information

NPI: 1053241612
Provider Name (Legal Business Name): RAFAELA CARDOSO LUCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8125 MIZNER LN
BOCA RATON FL
33433-1129
US

IV. Provider business mailing address

8125 MIZNER LN
BOCA RATON FL
33433-1129
US

V. Phone/Fax

Practice location:
  • Phone: 561-759-9930
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberPN5270665
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: