Basic Information
| Provider Information | |||||||||
| NPI: | 1528008349 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE ARMAS | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | O | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1206 ROYAL TERN DR | ||||||||
| Address2: | |||||||||
| City: | PUNTA GORDA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339507642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415758129 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4161 TAMIAMI TRL | ||||||||
| Address2: | 401 | ||||||||
| City: | PORT CHARLOTTE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339529208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412352710 | ||||||||
| FaxNumber: | 9412352712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3747A0650X | N | Nursing Service Related Providers | Technician | Attendant Care Provider | 363LA2200X | 1802912 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.