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General NPI Number Information
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NPI Number | 1194561894
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Entity Type | Individual
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Provider Name | DANIELLA ALEJANDRA SALAS
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Gender | Female
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 443 W COUNTY ROAD 419
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City | CHULUOTA
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State | FL
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Zip | 32766-9518
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Country | US
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Telephone | 407-366-2890
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Fax |
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Provider Business Mailing Address
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Address Line | 8580 NORTHLAKE PKWY
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City | ORLANDO
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State | FL
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Zip | 32827-6918
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Country | US
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Telephone | 407-446-8329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9118959
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License Number State | FL
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