Healthcare Provider Details

I. General information

NPI: 1457803967
Provider Name (Legal Business Name): DANIELLE AMARILIS HOF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5727 BAYWATER DR
TAMPA FL
33615-3568
US

IV. Provider business mailing address

5727 BAYWATER DR
TAMPA FL
33615-3568
US

V. Phone/Fax

Practice location:
  • Phone: 813-466-2841
  • Fax:
Mailing address:
  • Phone: 813-466-2841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberH100161948070
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: