Provider Demographics
NPI:1538691126
Name:ORESANYA, EASTER
Entity Type:Individual
Prefix:
First Name:EASTER
Middle Name:
Last Name:ORESANYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 MAINSHIP DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5978
Mailing Address - Country:US
Mailing Address - Phone:754-422-0059
Mailing Address - Fax:
Practice Address - Street 1:5503 MAINSHIP DR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5978
Practice Address - Country:US
Practice Address - Phone:754-422-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5166024164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse