MEDICARE: MS. DANYALE ELLIS

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	235Z00000X	Speech-Language Pathologist	37429	CA

General Provider Information

NPI Number	:	1811841901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANYALE ELLIS

Provider Business Mailing Address
First Line	:	4845 GULFSTREAM PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-6131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4845 GULFSTREAM PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-6131
Country	:	US
Telephone Number	:	813-385-1149
Fax Number	:

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

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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Directions to “ MS. DANYALE ELLIS ” Practice Location

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