Provider Demographics
NPI:1538324322
Name:BROWN, DANIELLE COLLEEN (LMT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:COLLEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 SW 45 ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9660
Mailing Address - Country:US
Mailing Address - Phone:352-857-3921
Mailing Address - Fax:
Practice Address - Street 1:5609 SW 45TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9660
Practice Address - Country:US
Practice Address - Phone:352-857-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 28781225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist