Provider Demographics
NPI:1760788848
Name:BURKE, DANIELLE RENEE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:RENEE
Last Name:BURKE
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 1:2475 BRICKELL AVE APT 2203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2483
Mailing Address - Country:US
Mailing Address - Phone:305-495-2251
Mailing Address - Fax:
Practice Address - Street 1:6705 RED ROAD
Practice Address - Street 2:SUITE 522
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33143-3649
Practice Address - Country:US
Practice Address - Phone:786-517-8650
Practice Address - Fax:786-517-8657
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105903363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant