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General NPI Number Information
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NPI Number | 1245999770
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Entity Type | Individual
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Provider Name | JOSHUA MCDANIEL PA
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Gender | Male
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 1514 NIRA ST
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8652
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Country | US
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Telephone | 904-387-4991
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Fax |
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Provider Business Mailing Address
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Address Line | 14227 TURKEY CREEK DR
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City | TALLAHASSEE
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State | FL
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Zip | 32312-8134
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Country | US
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Telephone | 850-566-7456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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