Provider Demographics
NPI:1134506736
Name:VENOSA, DANIELA (PSYD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:VENOSA
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 W SWANN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2478
Mailing Address - Country:US
Mailing Address - Phone:813-433-0182
Mailing Address - Fax:813-438-4742
Practice Address - Street 1:2111 W SWANN AVE STE 204
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2478
Practice Address - Country:US
Practice Address - Phone:813-433-0182
Practice Address - Fax:813-438-4742
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-03
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9688103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical