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General NPI Number Information
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NPI Number | 1972147759
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Entity Type | Individual
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Provider Name | ANTONELLA VANESSA GRANA DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 5915 PONCE DE LEON BLVD STE 23
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City | CORAL GABLES
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State | FL
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Zip | 33146-2435
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Country | US
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Telephone | 786-664-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 10400 SW 76TH ST
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City | MIAMI
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State | FL
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Zip | 33173-2903
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Country | US
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Telephone | 305-343-8533
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11004614
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11004614
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License Number State | FL
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