Provider Demographics
NPI:1366053506
Name:WOOLLEY, SYBIL (APRN)
Entity type:Individual
Prefix:
First Name:SYBIL
Middle Name:
Last Name:WOOLLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-3571
Mailing Address - Fax:305-243-4650
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-3571
Practice Address - Fax:305-243-4650
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9338285163W00000X
FLAPRN11008899363LF0000X
FLF06201807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11008899OtherFLORIDA BOARD OF NURSING
FLF06201807OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS