Provider Demographics
NPI:1760803126
Name:PHILLIPPE, DANIELLE RENEE (ARNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENEE
Last Name:PHILLIPPE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6149 CHANCELLOR DR STE 2780
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5633
Mailing Address - Country:US
Mailing Address - Phone:407-352-2542
Mailing Address - Fax:407-352-2547
Practice Address - Street 1:6149 CHANCELLOR DR STE 2780
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5633
Practice Address - Country:US
Practice Address - Phone:407-352-2542
Practice Address - Fax:407-352-2547
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9238143208M00000X
FLF1213276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116167500Medicaid