Provider Demographics
NPI:1659884534
Name:VILLAPANDO, GEMMA MERCADO (ARNP)
Entity Type:Individual
Prefix:
First Name:GEMMA
Middle Name:MERCADO
Last Name:VILLAPANDO
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 1:129 GLADESDOWN CT
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-7954
Mailing Address - Country:US
Mailing Address - Phone:386-748-7305
Mailing Address - Fax:
Practice Address - Street 1:129 GLADESDOWN CT
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-7954
Practice Address - Country:US
Practice Address - Phone:386-748-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9253408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily