Healthcare Provider Details

I. General information

NPI: 1043527849
Provider Name (Legal Business Name): SELINA KOZAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 FOREST HILL BLVD # 50-109
WEST PALM BEACH FL
33406-5813
US

IV. Provider business mailing address

3300 FOREST HILL BLVD # 50-109
WEST PALM BEACH FL
33406-5813
US

V. Phone/Fax

Practice location:
  • Phone: 561-437-6584
  • Fax:
Mailing address:
  • Phone: 561-437-6584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9210685
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: