Healthcare Provider Details

I. General information

NPI: 1952833964
Provider Name (Legal Business Name): DAYAMIS PENALVER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAYAMIS PENALVER APRN

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 11/14/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12709 MIRAMAR PKWY
MIRAMAR FL
33027-2902
US

IV. Provider business mailing address

1600 W OAKLAND PARK BLVD
OAKLAND PARK FL
33311-1520
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-2929
  • Fax:
Mailing address:
  • Phone: 754-200-8284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9439534
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11000055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: