Individual
EBU SCOHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1001 NW 13TH ST STE 100, BOCA RATON, FL 33486-2269
(305) 740-6140
(305) 740-6181
Mailing address
1001 NW 13TH ST STE 100, BOCA RATON, FL 33486-2269
(305) 740-6140
(305) 740-6181
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16685
CA
363A00000X
Physician Assistant
Primary
PA9120306
FL
Other
Enumeration date
09/14/2005
Last updated
06/08/2026
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