Female

Tyler S. Passalacqua PA-C

Medical Physician Assistant in Boca Raton, FL(View on Map)

Full Name

Tyler Stephanie Passalacqua PA-C

NPI Number

1225659147

NPI Type

Individual Provider

Gender

Female

Enumeration Date

05/01/2020

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA9113012

Contact
Information

Purpose

Mailing
Location

Address

4855 W HILLSBORO BLVD STE B-2
950 GLADES RD STE 4A

City

Coconut Creek
Boca Raton

State

FL
FL

Postal Code

33073
33431-6401

Country

US
US

Telephone Number

(954) 418-1683
(561) 391-8086

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/04/2022

Provider Address

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