Healthcare Provider Details

I. General information

NPI: 1831094911
Provider Name (Legal Business Name): ELZEN FLORENCIA BOLADO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4214 W PARK RD
HOLLYWOOD FL
33021-4246
US

IV. Provider business mailing address

4214 W PARK RD
HOLLYWOOD FL
33021-4246
US

V. Phone/Fax

Practice location:
  • Phone: 786-683-9274
  • Fax:
Mailing address:
  • Phone: 786-683-9274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11051460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: