Basic Information
Provider Information
NPI: 1811418205
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARANTE
FirstName: DANAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 38135 MARKET SQ
Address2:  
City: ZEPHYRHILLS
State: FL
PostalCode: 335427505
CountryCode: US
TelephoneNumber: 3525670188
FaxNumber: 8133555101
Practice Location
Address1: 2352 BRUCE B DOWNS BLVD STE 304
Address2:  
City: WESLEY CHAPEL
State: FL
PostalCode: 335449203
CountryCode: US
TelephoneNumber: 8139731304
FaxNumber: 8133555024
Other Information
ProviderEnumerationDate: 07/06/2017
LastUpdateDate: 07/11/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA9110343FLY193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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