Individual provider Active NPI

Vavanne Destin, APRN

  • Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1396541868
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11037897 Issued in FL
Practice address
8201 W Broward Blvd
Plantation, FL 33324-2701
Phone
(954) 476-3942
NPI assigned
Feb 24, 2025
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11037897 FL Primary

Addresses

Primary practice location

8201 W Broward Blvd
Plantation, FL 33324-2701

Mailing address

16263 SW 47TH CT
Miramar, FL 33027-6301
Phone (954) 440-8874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11037897FLMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1396541868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16263 SW 47TH CT",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276301",
            "telephone_number": "954-440-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "954-476-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTIN",
        "first_name": "VAVANNE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11037897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.