Provider Demographics
NPI:1003325481
Name:BERNAL DEL AGUA, DANAYSI (ARNP)
Entity Type:Individual
Prefix:
First Name:DANAYSI
Middle Name:
Last Name:BERNAL DEL AGUA
Suffix:
Gender:F
Credentials:ARNP
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 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-660-6300
Mailing Address - Fax:
Practice Address - Street 1:2333 W HILLSBOROUGH AVE STE 160
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603
Practice Address - Country:US
Practice Address - Phone:813-660-6300
Practice Address - Fax:813-660-6620
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9409775363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner