Healthcare Provider Details

I. General information

NPI: 1518643311
Provider Name (Legal Business Name): DESIREE COLONDRES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE MONES APRN

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6804 CECELIA DRIVE
NEW PORT RICHEY FL
34653-4935
US

IV. Provider business mailing address

6804 CECELIA DR
NEW PORT RICHEY FL
34653-4935
US

V. Phone/Fax

Practice location:
  • Phone: 855-232-0644
  • Fax: 888-546-0488
Mailing address:
  • Phone: 855-232-0644
  • Fax: 888-546-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11027160
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9409554
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: