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General NPI Number Information
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NPI Number | 1346877537
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Entity Type | Organization
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Legal Business Name | DANIELLE DEFREITAS LLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 910 NE 19TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3031
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Country | US
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Telephone | 754-800-4826
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 SE 2ND CT APT 209
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-3664
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Country | US
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Telephone | 954-552-0333
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MRS. DANIELLE SORIERO
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Credential | AP
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Telephone | 754-800-4826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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