Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME144294 | FL |
NPI | 1407918162 |
---|---|
Provider Name | Diane Louise Danly |
First Address | Temple Terrace, FL 33637-0904 |
Second Address | Temple Terrace, FL 33637-0904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 17/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8117699 | (05) | WA |
E17460 | (02) | WA |