Provider Demographics
NPI:1285660258
Name:SPECIALE, DANIEL FERDINAND (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:FERDINAND
Last Name:SPECIALE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD STE E120
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5353
Mailing Address - Country:US
Mailing Address - Phone:941-955-2020
Mailing Address - Fax:941-955-2120
Practice Address - Street 1:2831 RINGLING BLVD STE E120
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5353
Practice Address - Country:US
Practice Address - Phone:941-955-2020
Practice Address - Fax:941-955-2120
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10001794225100000X
FLPT38762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609695OtherIBC
2287299000OtherAMERIHEALTH
Q07020Medicare UPIN
DE013113F68Medicare ID - Type Unspecified