Mayra Dejesus, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

ARNP2114722 Issued in FL

Practice address

10739 Deerwood Park Blvd Ste 200
Jacksonville, FL 32256-4839

Phone

(904) 719-7707

Fax

(800) 266-5158

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1851743199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 MEADOWGOLD LN",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327926364",
            "telephone_number": "407-256-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10739 DEERWOOD PARK BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564839",
            "telephone_number": "904-719-7707",
            "fax_number": "800-266-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MAYRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "FL",
            "license": "2114722",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP2114722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Dehay, ARNP
• Savanna Dehner
• Amy Lee Deichert, MS-SP-CCC
• Judy L Deitrick, OPTICIAN
• Elizabeth Dejesus, PTA
• Bryana Dejoie
• Amber Renee Dekoschak, MD
• Maria Giselda Del Busto-Carames, PH.D.
• Onofre S Del Campo, M.D.
• Marienelle Romero Del Castillo, OT

• Gerontology Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.