Provider Demographics
NPI:1194220731
Name:DONARD, DANIELA
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:DONARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-4629
Mailing Address - Country:US
Mailing Address - Phone:561-856-0306
Mailing Address - Fax:
Practice Address - Street 1:334 LOPEZ PL
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3534
Practice Address - Country:US
Practice Address - Phone:561-856-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9337303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$Other$$$$$$$$$