Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | OS15409 | FL |
NPI | 1346668613 |
---|---|
Provider Name | Nicholas Cody Daley |
First Address | Jacksonville, FL 32244-5597 |
Second Address | Fernandina Beach, FL 32034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 18/04/2019 |