Healthcare Provider Details

I. General information

NPI: 1912445982
Provider Name (Legal Business Name): DELISA NANCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8325 NE 2ND AVE STE 101
MIAMI FL
33138-3815
US

IV. Provider business mailing address

20421 NW 7TH CT
MIAMI GARDENS FL
33169-2555
US

V. Phone/Fax

Practice location:
  • Phone: 833-362-3262
  • Fax:
Mailing address:
  • Phone: 904-294-7119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11036468
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: