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NPI Code Detail

MEDICARE: DANIELLE NICOLE WATERS MA CCC-SLP

MEDICARE: DANIELLE NICOLE WATERS MA CCC-SLP
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
1235Z00000XSpeech-Language PathologistSZ6765FL
2235Z00000XSpeech-Language PathologistSA14022FL

Other Identifiers

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

General Provider Information

NPI Number : 1558760355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE NICOLE WATERS MA CCC-SLP
Provider Business Mailing Address
First Line : 4657 LAKE CALABAY DR
Second Line :
City : ORLANDO
State : FL
Zip : 32837-5473
Country : US
Telephone Number : 407-312-8411
Fax Number :
Provider Business Practice Location Address
First Line : 4680 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-1182
Country : US
Telephone Number : 407-852-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2014
Last Update Date : 08/31/2021

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