Provider Demographics
NPI:1821583030
Name:ATIYEH, DANIELLE C (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:C
Last Name:ATIYEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:E
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1750 17TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-8690
Mailing Address - Country:US
Mailing Address - Phone:941-529-0200
Mailing Address - Fax:
Practice Address - Street 1:6950 OUTREACH WAY
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-3405
Practice Address - Country:US
Practice Address - Phone:941-529-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150407208000000X
FL150407208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty