Provider Demographics
NPI:1811408164
Name:ABRAHAM, DAYANA (ARNP-C)
Entity Type:Individual
Prefix:
First Name:DAYANA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18001 RICHMOND PLACE DR APT 727
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1746
Mailing Address - Country:US
Mailing Address - Phone:239-628-5238
Mailing Address - Fax:
Practice Address - Street 1:14540 CORTEZ BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6002
Practice Address - Country:US
Practice Address - Phone:352-597-4000
Practice Address - Fax:352-597-0550
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9356023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily