Provider Demographics
NPI:1033301601
Name:JAMIE D DANIEL MD PA
Entity Type:Organization
Organization Name:JAMIE D DANIEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-867-0215
Mailing Address - Street 1:1805 SE 16TH AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4672
Mailing Address - Country:US
Mailing Address - Phone:352-867-0215
Mailing Address - Fax:352-680-0688
Practice Address - Street 1:1805 SE 16TH AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4672
Practice Address - Country:US
Practice Address - Phone:352-867-0215
Practice Address - Fax:352-840-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0093416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8395Medicare UPIN