Provider Demographics
NPI:1477185072
Name:STAGNI, DANIELLE DELEON (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:DELEON
Last Name:STAGNI
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 ROBBINS REST CIR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-5202
Mailing Address - Country:US
Mailing Address - Phone:813-843-5153
Mailing Address - Fax:
Practice Address - Street 1:7450 DR PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5119
Practice Address - Country:US
Practice Address - Phone:407-973-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8064133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered