Provider Demographics
NPI:1649986050
Name:GUNDAYAO, HAZELMARIE SANTOS (APRN)
Entity type:Individual
Prefix:MRS
First Name:HAZELMARIE
Middle Name:SANTOS
Last Name:GUNDAYAO
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 1:961 HILLTOP PARK CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8304
Mailing Address - Country:US
Mailing Address - Phone:757-663-3341
Mailing Address - Fax:
Practice Address - Street 1:961 HILLTOP PARK CT
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-8304
Practice Address - Country:US
Practice Address - Phone:757-663-3341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily