Healthcare Provider Details

I. General information

NPI: 1235426347
Provider Name (Legal Business Name): DANI KORYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2011
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2454 N MCMULLEN BOOTH RD STE 606
CLEARWATER FL
33759-1345
US

IV. Provider business mailing address

2454 N MCMULLEN BOOTH RD STE 606
CLEARWATER FL
33759-1345
US

V. Phone/Fax

Practice location:
  • Phone: 551-277-4441
  • Fax: 201-392-3564
Mailing address:
  • Phone: 551-277-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberAU-29035998302
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA09561000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME126459
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD15486
License Number StateRI
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number48147
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: