Provider Demographics
NPI:1992794986
Name:MAXFIELD, DANE (DO)
Entity type:Individual
Prefix:
First Name:DANE
Middle Name:
Last Name:MAXFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:13644 WALSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3532
Mailing Address - Country:US
Mailing Address - Phone:727-595-2519
Mailing Address - Fax:727-631-0916
Practice Address - Street 1:13644 WALSINGHAM RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3532
Practice Address - Country:US
Practice Address - Phone:727-595-2519
Practice Address - Fax:727-631-0916
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS3688207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
591273247OtherUHC EMPIRE PLAN
FL10311OtherFLORIDA WELLCARE (MEDICARE PLAN)
FL212910OtherAVMED
FL3131464OtherCIGNA PPO/HMO, OPEN ACCESS, AND GREATWEST
FL388452OtherUNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS
FL82099OtherBLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS
710665OtherMAIL HANDLERS BENEFIT PLAN (MHBP)
FL10311OtherFLORIDA HEALTHEASE
FL119461500Medicaid
FL82099OtherOUT OF STATE BLUE CROSS BLUE SHIELD
FL82099OtherBCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE
100005888OtherRAILROAD MEDICARE
FL10311OtherFLORIDA STAYWELL
FL82099OtherOUT OF STATE BLUE CROSS BLUE SHIELD
E32144Medicare UPIN