Healthcare Provider Details

I. General information

NPI: 1104899889
Provider Name (Legal Business Name): DANNI LUTES DRISCOLL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANNI LUTES DRISCOLL M.D.

II. Dates (important events)

Enumeration Date: 02/11/2006
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 LINTON BLVD STE #250
DELRAY BEACH FL
33445-6600
US

IV. Provider business mailing address

4600 LINTON BLVD STE #250
DELRAY BEACH FL
33445-6600
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-0087
  • Fax: 561-495-0026
Mailing address:
  • Phone: 561-495-0087
  • Fax: 561-495-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME85254
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License NumberME85254
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME85254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: