Healthcare Provider Details

I. General information

NPI: 1326942095
Provider Name (Legal Business Name): PEDIATRIA NA FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 BROKEN SOUND PKWY NW APT 109
BOCA RATON FL
33487-3713
US

IV. Provider business mailing address

836 BROKEN SOUND PKWY NW APT 109
BOCA RATON FL
33487-3713
US

V. Phone/Fax

Practice location:
  • Phone: 754-207-2400
  • Fax:
Mailing address:
  • Phone: 754-207-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANA PAULA DE FARIA
Title or Position: MANAGING MEMBER
Credential: APRN, FNP-BC
Phone: 754-207-2400