Provider Demographics
NPI:1629356357
Name:DANNI DRISCOLL MD PA
Entity Type:Organization
Organization Name:DANNI DRISCOLL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-844-0120
Mailing Address - Street 1:1447 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3164
Mailing Address - Country:US
Mailing Address - Phone:561-844-0120
Mailing Address - Fax:561-800-1074
Practice Address - Street 1:1447 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-844-0120
Practice Address - Fax:561-800-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty