Provider Demographics
NPI:1033370952
Name:J DANIEL LABS MD PA
Entity Type:Organization
Organization Name:J DANIEL LABS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:LABS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-649-4263
Mailing Address - Street 1:720 GOODLETTE RD N
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5656
Mailing Address - Country:US
Mailing Address - Phone:239-649-4263
Mailing Address - Fax:
Practice Address - Street 1:720 GOODLETTE RD N
Practice Address - Street 2:SUITE 205
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5656
Practice Address - Country:US
Practice Address - Phone:239-649-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00615792082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty