Provider Demographics
NPI:1790295376
Name:LANUZA, GLAIZA (ARNP)
Entity Type:Individual
Prefix:
First Name:GLAIZA
Middle Name:
Last Name:LANUZA
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 1:4904 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3106
Mailing Address - Country:US
Mailing Address - Phone:407-619-8069
Mailing Address - Fax:
Practice Address - Street 1:4904 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3106
Practice Address - Country:US
Practice Address - Phone:407-619-8069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9299456363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9299456OtherFLORIDA BOARD OF NURSING