Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 288550 | NY |
Y | 207P00000X | Emergency Physician | ME135891 | FL |
NPI | 1013336718 |
---|---|
Provider Name | Dr. Daniel R Eraso |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 28/02/2020 |