Healthcare Provider Details

I. General information

NPI: 1487428736
Provider Name (Legal Business Name): DANIA MARIE GARGANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 GROOVER LOOP STE 201
SAINT AUGUSTINE FL
32086-6586
US

IV. Provider business mailing address

1200 16TH AVE S APT A
JACKSONVILLE BEACH FL
32250-3216
US

V. Phone/Fax

Practice location:
  • Phone: 904-634-0640
  • Fax: 904-634-0203
Mailing address:
  • Phone: 352-361-6517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11029429
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11029429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: