Provider Demographics
NPI:1417308099
Name:COMMAROTA, DANIELLE (REV RM, LME, BMSC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:COMMAROTA
Suffix:
Gender:F
Credentials:REV RM, LME, BMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 CONROY RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3565
Mailing Address - Country:US
Mailing Address - Phone:407-394-6128
Mailing Address - Fax:
Practice Address - Street 1:6735 CONROY RD
Practice Address - Street 2:SUITE 304
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3565
Practice Address - Country:US
Practice Address - Phone:407-394-6128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-25
Last Update Date:2016-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFB9741198174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist