Provider Demographics
NPI:1598227258
Name:VANESSA LAVINA MSN FNP-C LLC
Entity Type:Organization
Organization Name:VANESSA LAVINA MSN FNP-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LAVINA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-793-9770
Mailing Address - Street 1:14921 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8014
Mailing Address - Country:US
Mailing Address - Phone:305-793-9770
Mailing Address - Fax:
Practice Address - Street 1:14921 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33176-8014
Practice Address - Country:US
Practice Address - Phone:305-793-9770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty