Healthcare Provider Details

I. General information

NPI: 1407905201
Provider Name (Legal Business Name): DEANA MARIE ANGEL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MILITARY TRL 109
JUPITER FL
33458-7040
US

IV. Provider business mailing address

1025 MILITARY TRL 109
JUPITER FL
33458-7040
US

V. Phone/Fax

Practice location:
  • Phone: 561-741-0000
  • Fax: 561-741-0002
Mailing address:
  • Phone: 561-741-0000
  • Fax: 561-741-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9204418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: