Provider Demographics
NPI:1093705212
Name:FOXX, DAN L (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:L
Last Name:FOXX
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:DANNY
Other - Middle Name:L
Other - Last Name:FOXX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:7152 COCA SABAL LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4263
Mailing Address - Country:US
Mailing Address - Phone:239-939-9939
Mailing Address - Fax:239-931-5078
Practice Address - Street 1:7152 COCA SABAL LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4263
Practice Address - Country:US
Practice Address - Phone:239-939-9939
Practice Address - Fax:239-931-5078
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3324602367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL430070033OtherMCRR
FLG2987ZOtherMCR
FL304559500Medicaid
FLG2987OtherBSFL
FL304559500Medicaid