Provider Demographics
NPI:1316310089
Name:DAMBREVILLE, JUNE-ANN VANESSA (ARNP, FNP)
Entity type:Individual
Prefix:
First Name:JUNE-ANN
Middle Name:VANESSA
Last Name:DAMBREVILLE
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 1:2964 SANTA MARIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34715-8019
Mailing Address - Country:US
Mailing Address - Phone:407-406-4771
Mailing Address - Fax:
Practice Address - Street 1:745 ORIENTA AVE STE 1191
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6609
Practice Address - Country:US
Practice Address - Phone:407-331-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9232625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily