Provider Demographics
NPI:1144041211
Name:DURAN OLIVEROS, KATIANA (APRN)
Entity type:Individual
Prefix:
First Name:KATIANA
Middle Name:
Last Name:DURAN OLIVEROS
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 1:4929 GAMBERO WAY
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-5129
Mailing Address - Country:US
Mailing Address - Phone:305-316-4829
Mailing Address - Fax:
Practice Address - Street 1:5350 AVE MARIA BLVD
Practice Address - Street 2:UNIT 120
Practice Address - City:AVE MARIA
Practice Address - State:FL
Practice Address - Zip Code:34142
Practice Address - Country:US
Practice Address - Phone:239-624-0468
Practice Address - Fax:239-624-0464
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily