MEDICARE: DELAYNA SIQUEIRA FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11016345	FL

General Provider Information

NPI Number	:	1285390328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELAYNA SIQUEIRA FNP

Provider Business Mailing Address
First Line	:	1474 W GRANADA BLVD STE 455
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8240
Country	:	US
Telephone Number	:	386-231-4685
Fax Number	:	386-231-4687

Provider Business Practice Location Address
First Line	:	1474 W GRANADA BLVD STE 455
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8240
Country	:	US
Telephone Number	:	386-231-4685
Fax Number	:	386-231-4687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	01/09/2026

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