Healthcare Provider Details

I. General information

NPI: 1538059829
Provider Name (Legal Business Name): DANIELLA MAMPRE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8018 SW 63RD LN
GAINESVILLE FL
32608-5583
US

IV. Provider business mailing address

8018 SW 63RD LN
GAINESVILLE FL
32608-5583
US

V. Phone/Fax

Practice location:
  • Phone: 803-546-6853
  • Fax:
Mailing address:
  • Phone: 803-546-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN9593222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: