Provider Demographics
NPI:1861139990
Name:CEGLA, ITALIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:ITALIA
Middle Name:
Last Name:CEGLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ITALIA
Other - Middle Name:
Other - Last Name:DELGADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2521 JUNIOR ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8000
Mailing Address - Country:US
Mailing Address - Phone:386-774-5755
Mailing Address - Fax:386-774-0880
Practice Address - Street 1:2521 JUNIOR ST
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8000
Practice Address - Country:US
Practice Address - Phone:386-774-5755
Practice Address - Fax:386-774-0880
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019150363L00000X
FLAPRN11019150363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner