Provider Demographics
NPI:1942837224
Name:LITTLE, DANIELLE R (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3400
Mailing Address - Country:US
Mailing Address - Phone:321-841-3467
Mailing Address - Fax:407-253-2563
Practice Address - Street 1:10000 W COLONIAL DR STE 381
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3435
Practice Address - Country:US
Practice Address - Phone:321-841-3467
Practice Address - Fax:407-253-2563
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
FLME161868207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program