Provider Demographics
NPI:1407578743
Name:ROBLES, DANICA AMBER
Entity Type:Individual
Prefix:
First Name:DANICA AMBER
Middle Name:
Last Name:ROBLES
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 1:7207 GOLDEN WINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-3324
Mailing Address - Country:US
Mailing Address - Phone:904-389-1010
Mailing Address - Fax:
Practice Address - Street 1:7207 GOLDEN WINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-3324
Practice Address - Country:US
Practice Address - Phone:904-389-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant