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NPI Code Detail

MEDICARE: DANIEL C DAUBE JR MD LLC

MEDICARE: DANIEL C DAUBE JR MD LLC
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
1207YS0123XFacial Plastic Surgery PhysicianFL
2207Y00000XOtolaryngology PhysicianFL
3207YP0228XPediatric Otolaryngology PhysicianFL
4207YX0602XOtolaryngic Allergy PhysicianFL
5207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) PhysicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME0068517OTHERFLFLORIDA MEDICAL LICENSE

General Provider Information

NPI Number : 1457384497
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANIEL C DAUBE JR MD LLC
Provider Business Mailing Address
First Line : 200 DOCTORS DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4559
Country : US
Telephone Number : 850-784-7722
Fax Number : 850-784-6903
Provider Business Practice Location Address
First Line : 200 DOCTORS DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4559
Country : US
Telephone Number : 850-784-7722
Fax Number : 850-784-6903
Authorized Official
Title or Position : MEMBER
Name : DR. DANIEL CAMPBELL DAUBE JR.
Credential : M.D.
Telephone Number : 850-784-7722
Provider Enumeration Date : 07/09/2006
Last Update Date : 08/15/2013

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