Provider Demographics
NPI:1306261110
Name:DANDA, VENISE (DNP-APRN)
Entity type:Individual
Prefix:
First Name:VENISE
Middle Name:
Last Name:DANDA
Suffix:
Gender:F
Credentials:DNP-APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 NE 199TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3003
Mailing Address - Country:US
Mailing Address - Phone:786-201-3794
Mailing Address - Fax:305-391-3551
Practice Address - Street 1:190 NE 199TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2927
Practice Address - Country:US
Practice Address - Phone:786-589-7840
Practice Address - Fax:305-436-3817
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9335724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020337900Medicaid