Healthcare Provider Details

I. General information

NPI: 1417905621
Provider Name (Legal Business Name): LUCY MARINA TROVATO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 W HILLSBORO BLVD STE B13
COCONUT CREEK FL
33073-4365
US

IV. Provider business mailing address

4855 W HILLSBORO BLVD STE B13
COCONUT CREEK FL
33073-4365
US

V. Phone/Fax

Practice location:
  • Phone: 954-420-9182
  • Fax: 954-420-9184
Mailing address:
  • Phone: 954-480-9182
  • Fax: 954-420-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9396948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: