Basic Information
Provider Information
NPI: 1326525346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DISCHNER
FirstName: DANIELLE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STEPHENS
OtherFirstName: DANIELLE
OtherMiddleName: MARIE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 10002 PRINCESS PALM AVE STE 332
Address2:  
City: TAMPA
State: FL
PostalCode: 336198327
CountryCode: US
TelephoneNumber: 8135717184
FaxNumber: 8136544695
Practice Location
Address1: 3000 MEDICAL PARK DR STE 200
Address2:  
City: TAMPA
State: FL
PostalCode: 336134695
CountryCode: US
TelephoneNumber: 8138798045
FaxNumber: 8139783667
Other Information
ProviderEnumerationDate: 07/23/2018
LastUpdateDate: 01/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAY2200FLY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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