Provider Demographics
NPI:1659345700
Name:DEEMS, DANIEL A (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:DEEMS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8451 SHADE AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2878
Mailing Address - Country:US
Mailing Address - Phone:941-355-2767
Mailing Address - Fax:941-355-0617
Practice Address - Street 1:8451 SHADE AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2878
Practice Address - Country:US
Practice Address - Phone:941-355-2767
Practice Address - Fax:941-355-0617
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 72426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL231346OtherAETNA HMO
FL2267911 002OtherCIGNA
FL243108OtherAVMED
FL32861OtherBCBS
FL5904443OtherAETNA PPO
FL251697700Medicaid
FL040015343OtherRAILROAD MEDICARE
FL040015343OtherRAILROAD MEDICARE
FL251697700Medicaid