Healthcare Provider Details

I. General information

NPI: 1639436264
Provider Name (Legal Business Name): DANNY JOE MCLAUGHLIN RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S LINE AVE
INVERNESS FL
34452-4605
US

IV. Provider business mailing address

PO BOX 1925
LADY LAKE FL
32158-1925
US

V. Phone/Fax

Practice location:
  • Phone: 352-344-4791
  • Fax: 352-344-3822
Mailing address:
  • Phone: 352-553-4075
  • Fax: 888-770-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015566
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9107769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: