Provider Demographics
NPI:1255065314
Name:DE LA ROSA SANCHEZ, DAHIANA EULALIA (APRN)
Entity type:Individual
Prefix:
First Name:DAHIANA
Middle Name:EULALIA
Last Name:DE LA ROSA SANCHEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15680 SW 127TH AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10900 SE 174TH PLACE RD
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8984
Practice Address - Country:US
Practice Address - Phone:352-820-3401
Practice Address - Fax:352-820-3402
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9509100163W00000X
FLAPRN11022370363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse