Provider Demographics
NPI:1871935544
Name:DE SOUZA, PRISCILA NOGUEIRA (NP)
Entity type:Individual
Prefix:MRS
First Name:PRISCILA
Middle Name:NOGUEIRA
Last Name:DE SOUZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9862 PALMA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3500
Mailing Address - Country:US
Mailing Address - Phone:561-479-7915
Mailing Address - Fax:
Practice Address - Street 1:190 GLADES RD STE E
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1642
Practice Address - Country:US
Practice Address - Phone:561-338-4944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9169630363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health