MEDICARE: DANIEL R MCINTOSH

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	152WC0802X	Corneal and Contact Management Optometrist	FLOPC3198	FL
2	152WL0500X	Low Vision Rehabilitation Optometrist	FLOPC3198	FL
3	152WP0200X	Pediatric Optometrist	FLOPC3198	FL
4	152WS0006X	Sports Vision Optometrist	FLOPC3198	FL
5	152WV0400X	Vision Therapy Optometrist	FLOPC3198	FL
6	152WX0102X	Occupational Vision Optometrist	FLOPC3198	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	362194	OTHER	FL	CLARITY VISION/OPTICHOICE
2	918655	OTHER	FL	COLE VISION
3	F103198	OTHER	FL	VBA
4	153450	OTHER	FL	VSP/CIGNA
5	51565	OTHER	FL	DAVIS VISION
6	28377	OTHER	FL	SPECTERA
7	35700	OTHER	FL	AVESIS

General Provider Information

NPI Number	:	1598871048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL R MCINTOSH

Provider Business Mailing Address
First Line	:	3840 BELFORT RD STE 105
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6202
Country	:	US
Telephone Number	:	904-737-1975
Fax Number	:	904-737-1977

Provider Business Practice Location Address
First Line	:	3840 BELFORT RD STE 105
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6202
Country	:	US
Telephone Number	:	904-737-1975
Fax Number	:	904-737-1977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	09/11/2025

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Directions to “ DANIEL R MCINTOSH ” Practice Location

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