Healthcare Provider Details

I. General information

NPI: 1780992644
Provider Name (Legal Business Name): DANIEL HUNT II R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 ANCHOR AVE
DELAND FL
32720-2382
US

IV. Provider business mailing address

2160 ANCHOR AVENUE
DELAND FL
32720
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-6615
  • Fax: 386-736-1890
Mailing address:
  • Phone: 386-736-6615
  • Fax: 386-736-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number429340
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH011321
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32803
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0014527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: