Provider Demographics
NPI:1912662107
Name:DENIS, VENANSA
Entity type:Individual
Prefix:MISS
First Name:VENANSA
Middle Name:
Last Name:DENIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21692
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7032
Mailing Address - Country:US
Mailing Address - Phone:786-374-6317
Mailing Address - Fax:
Practice Address - Street 1:16201 NE 13TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4607
Practice Address - Country:US
Practice Address - Phone:786-955-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY56475363LP0808X
FLRBT-21-182255106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician