Individual
FERNANDA BACOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12435 SW 123RD TER, MIAMI, FL 33186-9007
(305) 560-7228
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 468-0226
(239) 468-0222
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2024102592
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11041659
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128290000
—
FL
Enumeration date
05/23/2025
Last updated
09/24/2025
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