Provider Demographics
NPI:1669460606
Name:DANUZ, WANDA ALEXANDRA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:ALEXANDRA
Last Name:DANUZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:W.
Other - Middle Name:ALEX
Other - Last Name:DANUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:10131 FOREST HILL BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6109
Mailing Address - Country:US
Mailing Address - Phone:561-798-6600
Mailing Address - Fax:561-753-3328
Practice Address - Street 1:10131 FOREST HILL BLVD STE 206
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6109
Practice Address - Country:US
Practice Address - Phone:561-798-6600
Practice Address - Fax:561-753-3328
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2788122363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303653700Medicaid
FL303653700Medicaid
FLP42114Medicare UPIN