Provider Demographics
NPI:1538788799
Name:ROBLA, DANIELLE ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:ROBLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7985 SW 125TH ST
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6060
Mailing Address - Country:US
Mailing Address - Phone:786-395-4711
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 87TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3635
Practice Address - Country:US
Practice Address - Phone:305-275-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1169564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant