Healthcare Provider Details

I. General information

NPI: 1679415905
Provider Name (Legal Business Name): DANIELLE MORAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 W NEWBERRY RD STE 302
GAINESVILLE FL
32605-6604
US

IV. Provider business mailing address

1015 NW 21ST AVE APT V55
GAINESVILLE FL
32609-3448
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-8902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11042662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: