Provider Demographics
NPI:1669079711
Name:BEAUVIL, DANIDE OVILMAR (RN)
Entity type:Individual
Prefix:MRS
First Name:DANIDE
Middle Name:OVILMAR
Last Name:BEAUVIL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 NW NORTH DELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2759
Mailing Address - Country:US
Mailing Address - Phone:561-574-7370
Mailing Address - Fax:
Practice Address - Street 1:5251 NW NORTH DELWOOD DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2759
Practice Address - Country:US
Practice Address - Phone:561-574-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9342580163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse