Provider Demographics
NPI:1467596700
Name:DAVID, MICHAEL DALY (DC, DACAN)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DALY
Last Name:DAVID
Suffix:
Gender:M
Credentials:DC, DACAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 US HIGHWAY 1
Mailing Address - Street 2:SUITE B6
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3879
Mailing Address - Country:US
Mailing Address - Phone:772-388-8788
Mailing Address - Fax:772-388-8819
Practice Address - Street 1:1623 US HIGHWAY 1
Practice Address - Street 2:SUITE B6
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3879
Practice Address - Country:US
Practice Address - Phone:772-388-8788
Practice Address - Fax:772-388-8819
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003399111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88511Medicare ID - Type Unspecified
FLT55859Medicare UPIN