Provider Demographics
NPI:1043876261
Name:KRAVITZ, DANIELLE (AP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KRAVITZ
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 CLINT MOORE RD APT 104
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-3342
Mailing Address - Country:US
Mailing Address - Phone:954-798-4610
Mailing Address - Fax:
Practice Address - Street 1:500 NE SPANISH RIVER BLVD STE 31-32A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4515
Practice Address - Country:US
Practice Address - Phone:561-789-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4037171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist