Healthcare Provider Details

I. General information

NPI: 1710558747
Provider Name (Legal Business Name): DANA GEBEROVICH APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 06/26/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2794 S FLAMINGO RD
DAVIE FL
33330-3802
US

IV. Provider business mailing address

1025 E HALLANDALE BEACH BLVD STE 15
HALLANDALE BEACH FL
33009-4478
US

V. Phone/Fax

Practice location:
  • Phone: 954-477-8228
  • Fax: 913-222-1703
Mailing address:
  • Phone: 954-477-8228
  • Fax: 913-222-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07210467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: