Doctor Name: | MRS. DANIELLE FAY THOMPSON |
NPI Number: | 1033414636 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA9105684 |
Business Practice Address: | 118 W Fairbanks Ave Winter Park, FL - 327894327 |
Business Phone Number: | 4076462235 |
Business Fax Number: | |
Mailing Address: | 118 W Fairbanks Ave, WINTER PARK |
State: | FL |
Postal Code: | 327894327 |
Phone Number: | 4076462235 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2011 |
NPI Last Update Date: | 04/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA9105684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |