Provider Demographics
NPI:1649257908
Name:BENDER, DANIEL HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HOWARD
Last Name:BENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 STATE ROAD 52
Mailing Address - Street 2:SUITE 21
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6784
Mailing Address - Country:US
Mailing Address - Phone:727-861-2277
Mailing Address - Fax:727-861-2062
Practice Address - Street 1:8811 STATE ROAD 52
Practice Address - Street 2:SUITE 21
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6784
Practice Address - Country:US
Practice Address - Phone:727-861-2277
Practice Address - Fax:727-861-2062
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2081P2900X2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6464300001OtherMEDICARE NSC
FLE18801Medicare UPIN
FL6464300001OtherMEDICARE NSC
FL6464300001Medicare NSC