Healthcare Provider Details

I. General information

NPI: 1891943403
Provider Name (Legal Business Name): DONIELLE CAMPBELL PARRISH PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SW 46TH CT SUITE 140
OCALA FL
34474-5708
US

IV. Provider business mailing address

3000 SW 35TH PL APT E303
GAINESVILLE FL
32608-9378
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-3058
  • Fax:
Mailing address:
  • Phone: 773-612-2725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number160003581
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA 21645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: