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General NPI Number Information
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NPI Number | 1871262634
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Entity Type | Individual
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Provider Name | DANIE MOLY COULOMBE
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Gender | Female
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 2400 N ORANGE BLOSSOM TRL STE 205
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City | KISSIMMEE
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State | FL
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Zip | 34744-2307
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Country | US
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Telephone | 407-944-5240
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 N ORANGE BLOSSOM TRL STE 205
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City | KISSIMMEE
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State | FL
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Zip | 34744-2307
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Country | US
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Telephone |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 11010414
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11010414
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License Number State | FL
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