Provider Demographics
NPI:1922758820
Name:BOGGS, TRIANA MONEZ (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:TRIANA
Middle Name:MONEZ
Last Name:BOGGS
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 WALDEN WOODS DR # 3491
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-7168
Mailing Address - Country:US
Mailing Address - Phone:813-365-9454
Mailing Address - Fax:813-798-6422
Practice Address - Street 1:1923 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2655
Practice Address - Country:US
Practice Address - Phone:863-683-4663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018205367A00000X
FLRN9583963163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care