Provider Demographics
NPI:1811512312
Name:ARNOLD, DAPHNNE (MBA)
Entity type:Individual
Prefix:
First Name:DAPHNNE
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE ALFRED
Mailing Address - State:FL
Mailing Address - Zip Code:33850-2752
Mailing Address - Country:US
Mailing Address - Phone:863-595-6510
Mailing Address - Fax:863-808-5430
Practice Address - Street 1:253 JAMES CIR
Practice Address - Street 2:
Practice Address - City:LAKE ALFRED
Practice Address - State:FL
Practice Address - Zip Code:33850-2752
Practice Address - Country:US
Practice Address - Phone:863-595-6510
Practice Address - Fax:863-808-5430
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013791200OtherMEDICAID WAIVER PROVIDER/AGENCY FOR PERSONS W/DISABILITIES