Provider Demographics
NPI:1255032769
Name:DE JESUS CARMOEGA, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:DE JESUS CARMOEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 CHAMPIONS CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-9631
Mailing Address - Country:US
Mailing Address - Phone:407-994-5600
Mailing Address - Fax:
Practice Address - Street 1:8135 CHAMPIONS CIRCLE
Practice Address - Street 2:APT 107
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-9631
Practice Address - Country:US
Practice Address - Phone:407-994-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula