Provider Demographics
NPI:1760147813
Name:OCASIO, VANESSA MARIE
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:OCASIO
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 1:396 23RD STREET OCEAN
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-2202
Mailing Address - Country:US
Mailing Address - Phone:407-924-9456
Mailing Address - Fax:
Practice Address - Street 1:3000 41ST STREET OCEAN
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2373
Practice Address - Country:US
Practice Address - Phone:786-652-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9506574163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse