Provider Demographics
NPI:1083492516
Name:ESTEVEZ, ANIELA (APRN)
Entity Type:Individual
Prefix:
First Name:ANIELA
Middle Name:
Last Name:ESTEVEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:3526 MARSH WREN ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1330
Mailing Address - Country:US
Mailing Address - Phone:863-602-1051
Mailing Address - Fax:
Practice Address - Street 1:3526 MARSH WREN ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1330
Practice Address - Country:US
Practice Address - Phone:863-602-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF09230534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily