Provider Demographics
NPI:1760501266
Name:FROHWEIN, DANIEL MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARC
Last Name:FROHWEIN
Suffix:
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 1:25 W CRYSTAL LAKE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4475
Mailing Address - Country:US
Mailing Address - Phone:407-254-2500
Mailing Address - Fax:407-254-2557
Practice Address - Street 1:25 W CRYSTAL LAKE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4475
Practice Address - Country:US
Practice Address - Phone:407-254-2500
Practice Address - Fax:407-254-2557
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70499208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2284127OtherCIGNA
FL3289828OtherAETNA
FLP00164597OtherRAILROAD MEDICARE
FL31472OtherBCBS
FLP00164597OtherRAILROAD MEDICARE
FL31472AMedicare UPIN