Healthcare Provider Details

I. General information

NPI: 1417217498
Provider Name (Legal Business Name): DANISHA GISELLE FIGUEROA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 03/19/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 KINGSLEY AVE STE 118
ORANGE PARK FL
32073-4525
US

IV. Provider business mailing address

1536 KINGSLEY AVE STE 118
ORANGE PARK FL
32073-4525
US

V. Phone/Fax

Practice location:
  • Phone: 904-298-2113
  • Fax: 904-298-1922
Mailing address:
  • Phone: 904-298-2113
  • Fax: 904-298-1922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18399
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME126154
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: