Healthcare Provider Details

I. General information

NPI: 1285690461
Provider Name (Legal Business Name): DELORI M DULANY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELORI M HOLDEN ARNP

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 06/04/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 N WICKHAM RD
MELBOURNE FL
32940-2239
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-268-4200
  • Fax: 321-253-4338
Mailing address:
  • Phone: 321-268-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9323161
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: