Provider Demographics
NPI:1265086805
Name:VANEGAS, GEMA (APRN)
Entity type:Individual
Prefix:
First Name:GEMA
Middle Name:
Last Name:VANEGAS
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 1:2330 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7608
Mailing Address - Country:US
Mailing Address - Phone:561-432-5849
Mailing Address - Fax:561-283-0677
Practice Address - Street 1:5867 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4300
Practice Address - Country:US
Practice Address - Phone:561-432-5849
Practice Address - Fax:561-283-0677
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001828363LF0000X, 363LF0000X
FLDH20090124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11001828OtherSTATE LICENSE