Provider Demographics
NPI:1376790022
Name:KIERNAN, DANIEL FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANCIS
Last Name:KIERNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6002 POINTE WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5531
Mailing Address - Country:US
Mailing Address - Phone:941-792-2020
Mailing Address - Fax:941-792-1089
Practice Address - Street 1:6002 POINTE WEST BLVD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5531
Practice Address - Country:US
Practice Address - Phone:941-792-2020
Practice Address - Fax:941-924-8669
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261453207W00000X
IL12506009207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03338727Medicaid
NYA400049118Medicare PIN
NYA400049255Medicare PIN