Basic Information
| Provider Information | |||||||||
| NPI: | 1356983092 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DANESHVAR | ||||||||
| FirstName: | PARVIN | ||||||||
| MiddleName: | DEIDRI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, APRN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3607 EGRET DR | ||||||||
| Address2: | |||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329018151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132156277 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 390 N COURTENAY PKWY | ||||||||
| Address2: | |||||||||
| City: | MERRITT ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329533456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216333162 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2019 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN9457423 | FL | N | Nursing Service Providers | Registered Nurse | 363LF0000X | F09220571 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.