Provider Demographics
NPI:1194799601
Name:PULICE, FRANCES A (PA)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:A
Last Name:PULICE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12109 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2951
Mailing Address - Country:US
Mailing Address - Phone:352-205-8981
Mailing Address - Fax:352-391-6498
Practice Address - Street 1:609 W HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4638
Practice Address - Country:US
Practice Address - Phone:352-726-9707
Practice Address - Fax:352-726-8763
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101467363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY08C7OtherBCBS
FL290923500Medicaid
FLP20150Medicare UPIN
FLE4909XMedicare PIN