Healthcare Provider Details

I. General information

NPI: 1386685113
Provider Name (Legal Business Name): DANIELLE WHYTAL GLENDYE MSN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146
US

IV. Provider business mailing address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-1515
  • Fax: 305-663-5948
Mailing address:
  • Phone: 305-661-1515
  • Fax: 305-663-5948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberSP008668
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number3406482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: