Provider Demographics
NPI:1275906687
Name:URDA, EMILIA (ARNP)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:URDA
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 1:501 E DANIA BEACH BLVD APT 5E
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004-3009
Mailing Address - Country:US
Mailing Address - Phone:954-687-4175
Mailing Address - Fax:
Practice Address - Street 1:501 E DANIA BEACH BLVD APT 5E
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-3009
Practice Address - Country:US
Practice Address - Phone:954-687-4175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9222164174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2014013397OtherANCC CERTIFICATION