Provider Demographics
NPI:1538104799
Name:BARTZ, DANIEL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:BARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 SW 4TH TER
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1421
Mailing Address - Country:US
Mailing Address - Phone:239-772-5582
Mailing Address - Fax:239-772-5215
Practice Address - Street 1:1316 SW 4TH TER
Practice Address - Street 2:SUITE 102
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1421
Practice Address - Country:US
Practice Address - Phone:239-772-5582
Practice Address - Fax:239-772-5215
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC640ZMedicare PIN
FLU98387Medicare UPIN