Provider Demographics
NPI:1144111618
Name:FISHER, DANIELLE LAUREN (PA-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LAUREN
Last Name:FISHER
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 1:2350 VANDERBILT BEACH RD STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2760
Mailing Address - Country:US
Mailing Address - Phone:239-356-3503
Mailing Address - Fax:
Practice Address - Street 1:2350 VANDERBILT BEACH RD STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2760
Practice Address - Country:US
Practice Address - Phone:239-356-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9119854363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant