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General NPI Number Information
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NPI Number | 1669930236
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Entity Type | Individual
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Provider Name | DANIELLE LUCIENNE LEBLANC CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2019
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Last Update Date | 03/03/2019
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Provider Practice Location Address
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Address Line | 5380 TECH DATA DR STE 101
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City | CLEARWATER
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State | FL
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Zip | 33760-3122
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Country | US
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Telephone | 727-573-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 7577 SW 87TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32608-8763
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Country | US
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Telephone | 352-872-2571
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 9368714
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License Number State | FL
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