=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659903904
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY UY MSN, APRN, FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2020
-----------------------------------------------------
Last Update Date | 02/05/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 GLADES RD STE 305
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33431-7348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-208-5809
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3039 TROPICAL TRL
-----------------------------------------------------
City | LANTANA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33462-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-313-0112
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11000067
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------