Provider Demographics
NPI:1013902261
Name:OBER, DANIEL H (PA)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:H
Last Name:OBER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 75TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3201
Mailing Address - Country:US
Mailing Address - Phone:941-761-1998
Mailing Address - Fax:941-761-3807
Practice Address - Street 1:6033 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-4402
Practice Address - Country:US
Practice Address - Phone:941-752-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102303363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292079400Medicaid
FLP00137887OtherRAIL ROAD MEDICARE
FLP00137887OtherRAIL ROAD MEDICARE
FL292079400Medicaid
U0323XMedicare PIN