Provider Demographics
NPI:1285137737
Name:THELUSMA, DANIELA (MSN, FNP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:THELUSMA
Suffix:
Gender:
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:119 N POWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8037
Mailing Address - Country:US
Mailing Address - Phone:954-366-6455
Mailing Address - Fax:
Practice Address - Street 1:301 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3687
Practice Address - Country:US
Practice Address - Phone:561-926-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2280986163W00000X
FL11009684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOV383Medicaid