Individual
DANIELLE JACQUELINE MARESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1368 N UNIVERSITY DR, PLANTATION, FL 33322-4734
(954) 577-0001
(954) 577-0030
Mailing address
1368 N UNIVERSITY DR, PLANTATION, FL 33322-4734
(954) 577-0001
(954) 577-0030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106459
FL
363AM0700X
Medical Physician Assistant
C0004683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0004683
PHYSICIAN ASSISTANT STATE LICENSE
MD
01
—
PA9106459
PA -LICENSE -FLORIDA
FL
Enumeration date
02/16/2012
Last updated
08/27/2020
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