Healthcare Provider Details

I. General information

NPI: 1033047907
Provider Name (Legal Business Name): PATRICIA THURBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5622 WELLESLEY PARK DR APT 104
BOCA RATON FL
33433-6785
US

IV. Provider business mailing address

5622 WELLESLEY PARK DR APT 104
BOCA RATON FL
33433-6785
US

V. Phone/Fax

Practice location:
  • Phone: 786-424-8054
  • Fax:
Mailing address:
  • Phone: 786-424-8054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1552915
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: