Provider Demographics
NPI:1881732196
Name:DANZIGER, JEFFREY ARLEN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ARLEN
Last Name:DANZIGER
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 1:2300 MAITLAND CENTER PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4129
Mailing Address - Country:US
Mailing Address - Phone:407-679-6400
Mailing Address - Fax:407-679-7988
Practice Address - Street 1:2300 MAITLAND CENTER PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4129
Practice Address - Country:US
Practice Address - Phone:407-679-6400
Practice Address - Fax:407-679-7988
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00497032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061763600Medicaid
FL061763600Medicaid
FL04570XMedicare ID - Type Unspecified