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NPI Code Detail

MEDICARE: DR. DANIELLE DESVALLONS M.D.

MEDICARE: DR. DANIELLE DESVALLONS M.D.
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
1207P00000XEmergency Medicine PhysicianME65786FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952318644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIELLE DESVALLONS M.D.
Provider Business Mailing Address
First Line : 7505 SW 173RD ST
Second Line :
City : VILLAGE OF PALMETTO BAY
State : FL
Zip : 33157-4838
Country : US
Telephone Number : 305-232-5451
Fax Number : 305-232-5401
Provider Business Practice Location Address
First Line : 9333 SW 152ND ST
Second Line :
City : VILLAGE OF PALMETTO BAY
State : FL
Zip : 33157-1778
Country : US
Telephone Number : 305-256-5001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 07/08/2007

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