Derita, Jeannette R

Derita, Jeannette R is an individual health care provider with primary practice located at 1690 Dunlawton Ave Ste 120 , Port Orange FL 32127-8980. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Derita, Jeannette R can be contacted via phone (386) 449-9650.

Contact Information

Primary practice address
1690 Dunlawton Ave Ste 120 Port Orange FL 32127-8980
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11009651 Florida

Profile Details

NPI number 1528666575
LBN Legal business name Derita, Jeannette R
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2020
Last updated Dec 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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