Provider Demographics
NPI:1447056197
Name:MASTRAPA, DANIA VILMA
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:VILMA
Last Name:MASTRAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIA
Other - Middle Name:VILMA
Other - Last Name:MASTRPA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5827 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2000
Mailing Address - Country:US
Mailing Address - Phone:561-844-9443
Mailing Address - Fax:561-472-9692
Practice Address - Street 1:941 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-4353
Practice Address - Country:US
Practice Address - Phone:561-518-7001
Practice Address - Fax:561-673-8034
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11037474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily