Provider Demographics
NPI:1447225966
Name:LENAS, ANITA (ARNP, CNM FNP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:LENAS
Suffix:
Gender:F
Credentials:ARNP, CNM FNP
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 380129
Mailing Address - Street 2:
Mailing Address - City:GRANDIN
Mailing Address - State:FL
Mailing Address - Zip Code:32138-0129
Mailing Address - Country:US
Mailing Address - Phone:386-659-2104
Mailing Address - Fax:
Practice Address - Street 1:1326 STATE ROAD 100
Practice Address - Street 2:
Practice Address - City:GRANDIN
Practice Address - State:FL
Practice Address - Zip Code:32138-0129
Practice Address - Country:US
Practice Address - Phone:386-659-2104
Practice Address - Fax:386-659-2196
Is Sole Proprietor?:No
Enumeration Date:2006-02-19
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 796842363LF0000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7618OtherBC/BS OF FLORIDA #
FL302635300Medicaid
FLARNP796842OtherLICENSE NUMBER
FLARNP796842OtherLICENSE NUMBER
FLK1996Medicare PIN