Provider Demographics
NPI:1124388954
Name:CARSON, DANIELLE PECH (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:PECH
Last Name:CARSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CORAL DR
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4309
Mailing Address - Country:US
Mailing Address - Phone:305-453-0244
Mailing Address - Fax:
Practice Address - Street 1:15955 SW 96TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1271
Practice Address - Country:US
Practice Address - Phone:786-467-3140
Practice Address - Fax:786-533-9695
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-27
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3392552163WE0003X
FL3392552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency