Provider Demographics
NPI:1578552907
Name:DALEY, JOSEPH C III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:DALEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 SE 9TH PL
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3003
Mailing Address - Country:US
Mailing Address - Phone:239-574-2644
Mailing Address - Fax:239-574-1451
Practice Address - Street 1:1031 SE 9TH PL
Practice Address - Street 2:UNIT 2
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-574-2644
Practice Address - Fax:239-574-1451
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88922207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00179098OtherRAILROAD PROVIDER NUMBER
4060590OtherCIGNA
7726647OtherAETNA
FL272031100Medicaid
FL82159OtherBC/BS
FL272031100Medicaid