Provider Demographics
NPI:1336974328
Name:FLORENDO, JOAN ASEJO (RN)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:ASEJO
Last Name:FLORENDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 HOLLOWHILL DR APT 915
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-1545
Mailing Address - Country:US
Mailing Address - Phone:979-436-4331
Mailing Address - Fax:
Practice Address - Street 1:11400 STATE HIGHWAY 30 STE 1102
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-7948
Practice Address - Country:US
Practice Address - Phone:979-485-5435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse