Provider Demographics
NPI:1336025410
Name:PONCE, DIANA MARCELA (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARCELA
Last Name:PONCE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARCELA
Other - Last Name:PONCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:17122 ORANGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17122 ORANGEWOOD DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4504
Practice Address - Country:US
Practice Address - Phone:813-297-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily