Provider Demographics
NPI:1770236523
Name:VARGAS, DANAY LUDY (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:DANAY
Middle Name:LUDY
Last Name:VARGAS
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:DANAY
Other - Middle Name:LUDY
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:4801 S CONGRESS AVE STE 400
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4746
Practice Address - Country:US
Practice Address - Phone:561-366-4100
Practice Address - Fax:561-439-2717
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017406363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114184100Medicaid