MEDICARE: DANIELLE MILTENBERG PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9117570	FL
2	363A00000X	Physician Assistant	PA19010	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083150874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MILTENBERG PA-C

Provider Business Mailing Address
First Line	:	414 W SUNSET RD STE 205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1771
Country	:	US
Telephone Number	:	210-564-8300
Fax Number	:	210-564-8399

Provider Business Practice Location Address
First Line	:	414 W SUNSET RD STE 205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1771
Country	:	US
Telephone Number	:	210-564-8300
Fax Number	:	210-564-8399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2017
Last Update Date	:	09/05/2025

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