Provider Demographics
NPI:1043758329
Name:OZOA, DELIA VILLANUEVA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DELIA
Middle Name:VILLANUEVA
Last Name:OZOA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 DREW ST. SUITE 101
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765
Mailing Address - Country:US
Mailing Address - Phone:727-507-1028
Mailing Address - Fax:727-754-9484
Practice Address - Street 1:2106 DREW ST STE 101
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3238
Practice Address - Country:US
Practice Address - Phone:727-507-1028
Practice Address - Fax:727-754-9484
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL812821907OtherMEDICAID, PRIVATE INSURANCE, VA, WORK COMPENSATION