Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN11001828 | FL |
N | 363LC1500X | Nurse Practitioner - Community Health | APRN11001828 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN11001828 | FL |
NPI | 1265086805 |
---|---|
Provider Name | Gema Vanegas |
First Address | Vero Beach, FL 32962-4312 |
Second Address | Vero Beach, FL 32962-4312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2019 |
Last Update Date | 17/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APRN11001828 | STATE LICENSE (01) | FL |