Provider Demographics
NPI:1285475731
Name:VAN BRAKEL, DANIELA PAOLA (APRN)
Entity type:Individual
Prefix:MS
First Name:DANIELA
Middle Name:PAOLA
Last Name:VAN BRAKEL
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:PAOLA
Other - Last Name:REYES BRACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:
Practice Address - Street 1:975 BAPTIST WAY STE 102
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:786-662-5610
Practice Address - Fax:786-533-9980
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033721363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner