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General NPI Number Information
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NPI Number | 1821897398
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Entity Type | Individual
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Provider Name | LISETTE VANESSA WINANS APRN
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1051 PORT MALABAR BLVD NE STE 4
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City | PALM BAY
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State | FL
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Zip | 32905-5153
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Country | US
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Telephone | 321-844-7001
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Fax | 321-622-6544
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Provider Business Mailing Address
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Address Line | PO BOX 361095
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City | MELBOURNE
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State | FL
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Zip | 32936-1095
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Country | US
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Telephone | 321-253-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11039647
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN9332416
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License Number State | FL
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