Active NPI
Desroches Medical Clinic LLC
- Family Nurse Practitioner
- Tampa, FL
National Provider Identifier
1720625775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- DESROCHES MEDICAL CLINIC LLC
- Practice address
- 10071 Montague St
Tampa, FL 33626-3362 - Phone
- (321) 208-2390
- NPI assigned
- Dec 9, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danielle Desroches
- Title
- Aprn
- Phone
- (321) 208-2390
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
10071 Montague St
Tampa, FL 33626-3362
Mailing address
10071 Montague St
Tampa, FL 33626-1855
Phone (321) 208-2390
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1720625775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10071 MONTAGUE ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336261855",
"telephone_number": "321-208-2390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10071 MONTAGUE ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336263362",
"telephone_number": "321-208-2390"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DESROCHES MEDICAL CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-09",
"last_updated": "2023-03-07",
"certification_date": "2019-12-09",
"status": "A",
"authorized_official_last_name": "DESROCHES",
"authorized_official_first_name": "DANIELLE",
"authorized_official_title_or_position": "APRN",
"authorized_official_telephone_number": "321-208-2390"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.