Healthcare Provider Details

I. General information

NPI: 1114850161
Provider Name (Legal Business Name): DANIELLE DICARLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

7653 NW 79TH AVE APT 212
TAMARAC FL
33321-2874
US

IV. Provider business mailing address

7653 NW 79TH AVE APT 212
TAMARAC FL
33321-2874
US

V. Phone/Fax

Practice location:
  • Phone: 305-527-2907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: