Provider Demographics
NPI:1891890265
Name:POPE, DANIEL BALL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BALL
Last Name:POPE
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 1:426 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRANDENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8845
Mailing Address - Country:US
Mailing Address - Phone:941-708-9000
Mailing Address - Fax:941-746-7365
Practice Address - Street 1:426 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRANDENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8845
Practice Address - Country:US
Practice Address - Phone:941-708-9000
Practice Address - Fax:941-746-7365
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041584207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067434600Medicaid
FL180002133OtherRRMC
650244218001OtherTRICARE
FL180002133OtherRRMC
FL41208Medicare PIN