MEDICARE: MRS. DANIELLE MEANS

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	1041C0700X	Clinical Social Worker	SW12858	FL
2	101YM0800X	Mental Health Counselor	SW12858	FL

General Provider Information

NPI Number	:	1134842396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE MEANS

Provider Business Mailing Address
First Line	:	PO BOX 560130
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32856-0130
Country	:	US
Telephone Number	:	772-530-4583
Fax Number	:

Provider Business Practice Location Address
First Line	:	3240 WICKERSHAM CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6324
Country	:	US
Telephone Number	:	772-530-4583
Fax Number	:

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

Provider Enumeration Date	:	09/22/2022
Last Update Date	:	11/03/2022

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