Provider Demographics
NPI:1932408028
Name:RODNEY, DEENA MICHELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:MICHELLE
Last Name:RODNEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH MAITLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-647-5996
Mailing Address - Fax:407-644-5967
Practice Address - Street 1:301 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4723
Practice Address - Country:US
Practice Address - Phone:407-647-5996
Practice Address - Fax:407-644-5967
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9212728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily