Healthcare Provider Details

I. General information

NPI: 1053924480
Provider Name (Legal Business Name): VANITA VERMA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LINTON BLVD STE E300
DELRAY BEACH FL
33445-6597
US

IV. Provider business mailing address

4344 NW 65TH TER
CORAL SPRINGS FL
33067-3035
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-1973
  • Fax:
Mailing address:
  • Phone: 954-305-7545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9342155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: