Provider Demographics
NPI:1407536410
Name:RODGERS, DANIELLE ASHLE (CAA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ASHLE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4569 NW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4771
Mailing Address - Country:US
Mailing Address - Phone:786-308-1803
Mailing Address - Fax:
Practice Address - Street 1:1525 W CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:850-385-0144
Practice Address - Fax:850-385-0146
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant