Provider Demographics
NPI:1144211012
Name:GORSKI, DANIEL W (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:GORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-2479
Mailing Address - Country:US
Mailing Address - Phone:239-595-6575
Mailing Address - Fax:
Practice Address - Street 1:462 KENDALL DR
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2479
Practice Address - Country:US
Practice Address - Phone:239-595-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84885207L00000X
FLME84885207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264627700Medicaid
52010OtherBLUE CROSS BLUE SHIELD
52010OtherBLUE CROSS BLUE SHIELD
FL264627700Medicaid