MEDICARE: DELISA NANCE

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	363L00000X	Nurse Practitioner	APRN11036468	FL
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1912445982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELISA NANCE

Provider Business Mailing Address
First Line	:	20421 NW 7TH CT
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-2555
Country	:	US
Telephone Number	:	904-294-7119
Fax Number	:

Provider Business Practice Location Address
First Line	:	8325 NE 2ND AVE STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3815
Country	:	US
Telephone Number	:	833-362-3262
Fax Number	:

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

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	12/29/2025

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Directions to “ DELISA NANCE ” Practice Location

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