MEDICARE: NORTH PORT PODIATRY CENTER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3256	FL

General Provider Information

NPI Number	:	1437302601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH PORT PODIATRY CENTER PA

Provider Business Mailing Address
First Line	:	14580 TAMIAMI TRL UNIT H
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-2708
Country	:	US
Telephone Number	:	941-429-1702
Fax Number	:	941-429-0981

Provider Business Practice Location Address
First Line	:	14580 TAMIAMI TRL UNIT H
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-2708
Country	:	US
Telephone Number	:	941-429-1702
Fax Number	:	941-429-0981

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID B DANIELSON
Credential	:	DPM
Telephone Number	:	941-429-1702

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	02/12/2021

Similar Medicare Providers

1821179755 — DR. DAVID B DANIELSON D.P.M.
Practice Location Address:

14580 TAMIAMI TRL UNIT H
NORTH PORT, FL
34287-2708

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1205442563 — PHILIP JAMES NANULA JR. PT
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34287-2708

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1033998612 — JENNIFER M THOENNISSEN PTA
Practice Location Address:

14580 TAMIAMI TRL # DE
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1346056710 — JAY MICHAEL WILHELM PT, DPT
Practice Location Address:

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Practice Fax: 941-218-5627

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