Provider Demographics
NPI:1639661424
Name:BELL, DANIELLE FLAREAU (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:FLAREAU
Last Name:BELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5847 LONG BAYOU WAY S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-3550
Mailing Address - Country:US
Mailing Address - Phone:727-403-2637
Mailing Address - Fax:
Practice Address - Street 1:711 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6326
Practice Address - Country:US
Practice Address - Phone:727-314-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical