Individual provider · Type 1 NPI

Tyler Stephanie Passalacqua, PA-C

Medical Physician Assistant · Boca Raton, FL

NPI number 1225659147 Active

Practice location

950 Glades Rd Ste 4A
Boca Raton, FL 33431-6401

Call (561) 391-8086 Map

Fax (954) 418-1698

Mailing address

4855 W Hillsboro Blvd Ste B-2
Coconut Creek, FL 33073

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9113012 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1225659147

Tyler Stephanie Passalacqua, PA-C's National Provider Identifier is 1225659147, issued on May 1, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boca Raton, FL. The record was last updated on Feb 4, 2022.