MEDICARE: DANIELLE MONIQUE DAVID

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1336949304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MONIQUE DAVID

Provider Business Mailing Address
First Line	:	1845 TOWN CENTER BLVD STE 205
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-3359
Country	:	US
Telephone Number	:	904-319-4962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 TOWN CENTER BLVD STE 205
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-3359
Country	:	US
Telephone Number	:	904-319-4962
Fax Number	:

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

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	03/18/2025

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Directions to “ DANIELLE MONIQUE DAVID ” Practice Location

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