Provider Demographics
NPI:1154799104
Name:CONDE, DYENANN B (ARNP, FNP)
Entity type:Individual
Prefix:
First Name:DYENANN
Middle Name:B
Last Name:CONDE
Suffix:
Gender:F
Credentials:ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8260 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3808
Mailing Address - Country:US
Mailing Address - Phone:305-757-9555
Mailing Address - Fax:
Practice Address - Street 1:8260 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-3808
Practice Address - Country:US
Practice Address - Phone:305-757-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2716362363L00000X
FLF1114452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner