Healthcare Provider Details

I. General information

NPI: 1861286973
Provider Name (Legal Business Name): ELLA MAE PEREIRA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 W YAMATO RD STE 104
BOCA RATON FL
33431-4478
US

IV. Provider business mailing address

999 W YAMATO RD STE 104
BOCA RATON FL
33431-4478
US

V. Phone/Fax

Practice location:
  • Phone: 561-768-4672
  • Fax: 334-679-4870
Mailing address:
  • Phone: 561-768-4672
  • Fax: 334-679-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11039247
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11039247
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: