Provider Demographics
NPI:1629377866
Name:DAKA, EMILY AMANDA (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:AMANDA
Last Name:DAKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:700 8TH AVE W
Mailing Address - Street 2:STE 101
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4008
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:12271 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8410
Practice Address - Country:US
Practice Address - Phone:941-776-4050
Practice Address - Fax:941-776-4057
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9015998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant