Healthcare Provider Details

I. General information

NPI: 1306261110
Provider Name (Legal Business Name): VENISE DANDA DNP-APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 NE 199TH ST STE 201
MIAMI FL
33179-2927
US

IV. Provider business mailing address

585 NE 199TH TER
MIAMI FL
33179-3003
US

V. Phone/Fax

Practice location:
  • Phone: 786-589-7840
  • Fax: 305-436-3817
Mailing address:
  • Phone: 786-201-3794
  • Fax: 305-391-3551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9335724
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: