MEDICARE: DANZELLE L HOPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1063043073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANZELLE L HOPE

Provider Business Mailing Address
First Line	:	3200 NW 171ST ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4233
Country	:	US
Telephone Number	:	305-399-1102
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 NW 171ST ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4233
Country	:	US
Telephone Number	:	305-399-1102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	01/29/2020

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Directions to “ DANZELLE L HOPE ” Practice Location

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