Healthcare Provider Details

I. General information

NPI: 1619895430
Provider Name (Legal Business Name): DANIELLE ELYSE KLEEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6182 N US HIGHWAY 41 UNIT A
APOLLO BEACH FL
33572-1805
US

IV. Provider business mailing address

1220 E CUMBERLAND AVE UNIT 435
TAMPA FL
33602-4241
US

V. Phone/Fax

Practice location:
  • Phone: 813-771-0329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32170
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: