Provider Demographics
NPI:1457358590
Name:PICARD, DANIEL ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ADAM
Last Name:PICARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1776 WOODSTEAD CT STE 208
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1480
Mailing Address - Country:US
Mailing Address - Phone:877-749-7428
Mailing Address - Fax:512-628-3314
Practice Address - Street 1:1700 S 23RD ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4803
Practice Address - Country:US
Practice Address - Phone:877-749-7428
Practice Address - Fax:512-628-3314
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61639207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1287004OtherUNITED HEALTH CARE
FL3231812OtherAETNA PPO
FLW8P01OtherEMPIRE BCBS
FL270423OtherAMERIGROUP
FL5325021OtherAETNA HMO
FL611448083OtherHUMANA
FL5483381OtherCIGNA
FL15029OtherBCBS FLORIDA
FL1522170OtherHIGHMARK BCBS
FL373448000Medicaid
FLP00029704OtherPALMETTO GBA
FL126029000OtherUS DEPT OF LABOR
FL9727882OtherGHI
FL270423OtherAMERIGROUP
FL5325021OtherAETNA HMO