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General NPI Number Information
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NPI Number | 1760981641
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Entity Type | Individual
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Provider Name | DANIEL JAMES RAY
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Gender | Male
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 20311 GRANDE OAK SHOPPES BLVD
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City | ESTERO
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State | FL
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Zip | 33928-7662
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Country | US
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Telephone | 239-495-9013
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Fax | 239-495-7638
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Provider Business Mailing Address
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Address Line | 22950 FOREST RIDGE DR
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City | ESTERO
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State | FL
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Zip | 33928-4327
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Country | US
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Telephone | 636-248-2062
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS17233
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License Number State | FL
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