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NPI Code Detail

MEDICARE: MRS. DANIELLE SARAH GILLMAN

MEDICARE: MRS. DANIELLE SARAH GILLMAN
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
1106S00000XBehavior Technician

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 : 1770178311
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLE SARAH GILLMAN
Provider Business Mailing Address
First Line : 3891 STIRLING RD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-6216
Country : US
Telephone Number : 954-774-0469
Fax Number :
Provider Business Practice Location Address
First Line : 3891 STIRLING RD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-6216
Country : US
Telephone Number : 954-774-0469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2021
Last Update Date : 09/20/2021

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