Provider Demographics
NPI:1154614089
Name:TERAN, ARDIANA MALOKU (CPNP)
Entity type:Individual
Prefix:
First Name:ARDIANA
Middle Name:MALOKU
Last Name:TERAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:835 7TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2190
Mailing Address - Country:US
Mailing Address - Phone:352-404-8961
Mailing Address - Fax:352-404-8996
Practice Address - Street 1:835 7TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2190
Practice Address - Country:US
Practice Address - Phone:352-404-8961
Practice Address - Fax:352-404-8996
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2012-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9261560363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics