Individual
SHERLEY MARDEL DAVID GRATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
4777 N CONGRESS AVE, BOYNTON BEACH, FL 33426-7941
(561) 425-5085
(561) 209-5167
Mailing address
4777 N CONGRESS AVE, BOYNTON BEACH, FL 33426-7941
(561) 425-5085
(561) 209-5167
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
9407209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102092000
—
FL
Enumeration date
08/23/2017
Last updated
01/03/2025
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