Provider Demographics
NPI:1053173120
Name:COMPASSIONATE CARE NP LLC
Entity type:Organization
Organization Name:COMPASSIONATE CARE NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:507-629-0598
Mailing Address - Street 1:1650 S DIXIE HWY STE 200B
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7401
Mailing Address - Country:US
Mailing Address - Phone:954-669-4075
Mailing Address - Fax:
Practice Address - Street 1:1650 S DIXIE HWY STE 200B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7401
Practice Address - Country:US
Practice Address - Phone:954-669-4075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty