Provider Demographics
NPI:1922699933
Name:PHELPS, DANIEL CHRISTOPHER (PHD, RRT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHRISTOPHER
Last Name:PHELPS
Suffix:
Gender:M
Credentials:PHD, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-2856
Mailing Address - Country:US
Mailing Address - Phone:412-296-0324
Mailing Address - Fax:
Practice Address - Street 1:401 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-2856
Practice Address - Country:US
Practice Address - Phone:412-296-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT165652279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care