Healthcare Provider Details

I. General information

NPI: 1215483508
Provider Name (Legal Business Name): DANITA COBB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S ORANGE BLOSSOM TRL STE 236
ORLANDO FL
32805-3196
US

IV. Provider business mailing address

750 SOUTH ORANGE BLOSSOM TRAIL. SUITE 236
ORLANDO FL
32805
US

V. Phone/Fax

Practice location:
  • Phone: 407-717-4164
  • Fax: 407-205-1128
Mailing address:
  • Phone: 407-717-4164
  • Fax: 407-205-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number30212394
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number235250
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30212394
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: