Provider Demographics
NPI:1760734057
Name:DIGENNARO, DANIELLE FOTI (ANP-BC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:FOTI
Last Name:DIGENNARO
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100283
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0283
Mailing Address - Country:US
Mailing Address - Phone:235-265-0651
Mailing Address - Fax:
Practice Address - Street 1:INTERNAL MEDICINE/PALLIATIVE CARE 100283
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2299
Practice Address - Country:US
Practice Address - Phone:352-379-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9430453363LA2200X
CA95033094363LA2200X
NC5005815363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019868900Medicaid