Provider Demographics
NPI:1013499862
Name:DANAJ, MIRELA (APRN)
Entity type:Individual
Prefix:MS
First Name:MIRELA
Middle Name:
Last Name:DANAJ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 SE CHARLESTON DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7005
Mailing Address - Country:US
Mailing Address - Phone:954-245-5922
Mailing Address - Fax:
Practice Address - Street 1:160 NW 170TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5521
Practice Address - Country:US
Practice Address - Phone:786-466-7156
Practice Address - Fax:305-355-2044
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAANP000043363L00000X
TN0000035358363L00000X
FL9357385363L00000X, 363LA2100X
NYF432586363LA2100X
NC5019947363LA2100X
VA0024183774363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAKE9VOtherBCBS
FL102149200Medicaid