Healthcare Provider Details

I. General information

NPI: 1134844376
Provider Name (Legal Business Name): CAROLINA DEL PILAR CUERVO GASCA APRN FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 W ATLANTIC AVE
DELRAY BEACH FL
33445-4425
US

IV. Provider business mailing address

2475 W ATLANTIC AVE
DELRAY BEACH FL
33445-4425
US

V. Phone/Fax

Practice location:
  • Phone: 561-868-2999
  • Fax:
Mailing address:
  • Phone: 561-868-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11018996
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: