Provider Demographics
NPI:1881735777
Name:HILLIS, DANIEL P (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:HILLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:P
Other - Last Name:HILLIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5500 BRYSON DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0922
Mailing Address - Country:US
Mailing Address - Phone:239-597-3929
Mailing Address - Fax:239-597-3348
Practice Address - Street 1:5500 BRYSON DR
Practice Address - Street 2:SUITE 303
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0922
Practice Address - Country:US
Practice Address - Phone:239-597-3929
Practice Address - Fax:239-597-3348
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55492OtherBLUE CROSS BLUE SHEILD