Individual
DANIELLE MARIE OLSON-BASORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2495 PALM RIDGE RD, SANIBEL, FL 33957-3201
(239) 343-6990
(239) 343-4247
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6990
(239) 343-4247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301113524
MI
207Q00000X
Family Medicine Physician
Primary
ME164568
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119434800
—
FL
Enumeration date
03/27/2014
Last updated
10/06/2023
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