Healthcare Provider Details

I. General information

NPI: 1023593142
Provider Name (Legal Business Name): DANIELLE LYNN DECUBELLIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 SERANO WAY UNIT 101
NOKOMIS FL
34275-5241
US

IV. Provider business mailing address

5621 MAUNA LOA BLVD UNIT 206
SARASOTA FL
34240-7045
US

V. Phone/Fax

Practice location:
  • Phone: 941-484-8222
  • Fax:
Mailing address:
  • Phone: 941-993-5082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9384250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: