Provider Demographics
NPI:1285627240
Name:DAGGETT, DEANNE I (MD)
Entity Type:Individual
Prefix:DR
First Name:DEANNE
Middle Name:I
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 US HIGHWAY 1 FL 2
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4625
Mailing Address - Country:US
Mailing Address - Phone:561-402-7600
Mailing Address - Fax:561-529-4161
Practice Address - Street 1:630 US HIGHWAY 1 FL 2
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4625
Practice Address - Country:US
Practice Address - Phone:561-402-7600
Practice Address - Fax:561-529-4161
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035079207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001350793Medicaid
CT050000939Medicare ID - Type Unspecified
CT001350793Medicaid