Provider Demographics
NPI:1275588303
Name:WOHL, DANIEL L (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:WOHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11945 SAN JOSE BLVD
Mailing Address - Street 2:BLDG 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1613
Mailing Address - Country:US
Mailing Address - Phone:904-396-1725
Mailing Address - Fax:904-399-1717
Practice Address - Street 1:4114 SUNBEAM RD
Practice Address - Street 2:SUITE 403
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8847
Practice Address - Country:US
Practice Address - Phone:904-262-7368
Practice Address - Fax:904-262-7655
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME61718207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259148100Medicaid
FLE83541Medicare UPIN
FL35299Medicare ID - Type Unspecified