Provider Demographics
NPI:1225141468
Name:HIGGINS, DANIEL ROLAND (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROLAND
Last Name:HIGGINS
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 1:1 TAMPA GENERAL CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3571
Mailing Address - Country:US
Mailing Address - Phone:813-844-7000
Mailing Address - Fax:
Practice Address - Street 1:1201 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3515
Practice Address - Country:US
Practice Address - Phone:561-655-4334
Practice Address - Fax:561-655-4864
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044715208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1687756OtherCIGNA
FL258925700Medicaid
FL7436OtherDIMENSION
FL61477OtherBCBS
FL969146OtherWELLCARE
FLP1036219OtherFREEDOM
FL650752513OtherTAX ID
FLP01607921OtherRR MEDICARE
FLP971850OtherOPTIMUM
FL4008104OtherAETNA
FL208946OtherAVMED
FL61477VMedicare PIN
FLP01607921OtherRR MEDICARE
FL4008104OtherAETNA