Provider Demographics
NPI:1013086917
Name:MCAULEY, DARREN C (DO)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:C
Last Name:MCAULEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2600 LAKE LUCIEN DR STE 112
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7233
Mailing Address - Country:US
Mailing Address - Phone:321-207-9029
Mailing Address - Fax:844-410-7960
Practice Address - Street 1:2600 LAKE LUCIEN DR STE 112
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7233
Practice Address - Country:US
Practice Address - Phone:321-207-9029
Practice Address - Fax:844-410-7960
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013311204C00000X, 207RA0401X, 204D00000X
FLOS16689208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA119321K7AMedicare PIN