Healthcare Provider Details

I. General information

NPI: 1336043587
Provider Name (Legal Business Name): COURTNEY URICOECHEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 FL-7 SUITE 270
BOYNTON BEACH FL
33472
US

IV. Provider business mailing address

9787 SADDLE CT
LAKE WORTH FL
33467-3529
US

V. Phone/Fax

Practice location:
  • Phone: 561-371-6019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11051110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: