=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649257908
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL HOWARD BENDER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2005
-----------------------------------------------------
Last Update Date | 05/16/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8811 STATE ROAD 52 SUITE 21
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34667-6784
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-861-2277
-----------------------------------------------------
Fax | 727-861-2062
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8811 STATE ROAD 52 SUITE 21
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34667-6784
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-861-2277
-----------------------------------------------------
Fax | 727-861-2062
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | 2081P2900X
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------