Provider Demographics
NPI:1114969151
Name:ALBRITTON, DANIELLE L (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:L
Last Name:ALBRITTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:LEE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:14010 21ST ST
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-3915
Mailing Address - Country:US
Mailing Address - Phone:352-567-3325
Mailing Address - Fax:352-567-3385
Practice Address - Street 1:14010 21ST ST
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-3915
Practice Address - Country:US
Practice Address - Phone:352-567-3325
Practice Address - Fax:352-567-3385
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79153OtherBCBS
FL267884500Medicaid
H88239Medicare UPIN
FL79153YMedicare PIN
P00322914Medicare PIN