Provider Demographics
NPI:1376810994
Name:VANEGAS, DIANA MARCELA (LPN)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:MARCELA
Last Name:VANEGAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 FRANKLIN CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-6300
Mailing Address - Country:US
Mailing Address - Phone:727-455-8033
Mailing Address - Fax:
Practice Address - Street 1:888 FRANKLIN CIR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-6300
Practice Address - Country:US
Practice Address - Phone:727-455-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5201821164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse