Provider Demographics
NPI:1902897994
Name:DANNA, PENNY A (MD)
Entity Type:Individual
Prefix:DR
First Name:PENNY
Middle Name:A
Last Name:DANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 OUTER RD STE A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6652
Mailing Address - Country:US
Mailing Address - Phone:407-898-6588
Mailing Address - Fax:407-896-3785
Practice Address - Street 1:867 OUTER RD STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6652
Practice Address - Country:US
Practice Address - Phone:407-898-6588
Practice Address - Fax:407-896-3785
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63066207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375812500Medicaid
FL375812500Medicaid
27229ZMedicare PIN