Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH0003399 | FL |
NPI | 1467596700 |
---|---|
Provider Name | Dr. Michael Daly David |
First Address | Sebastian, FL 32958-3879 |
Second Address | Sebastian, FL 32958-3879 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 19/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55859 | (02) | FL |