MEDICARE: DANNI LUTES DRISCOLL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME85254	FL
2	207LA0401X	Addiction Medicine (Anesthesiology) Physician	ME85254	FL
3	207L00000X	Anesthesiology Physician	ME85254	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104899889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNI LUTES DRISCOLL MD

Provider Business Mailing Address
First Line	:	4600 LINTON BLVD
Second Line	:	STE #250
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6600
Country	:	US
Telephone Number	:	561-495-0087
Fax Number	:	561-495-0026

Provider Business Practice Location Address
First Line	:	4600 LINTON BLVD
Second Line	:	STE #250
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6600
Country	:	US
Telephone Number	:	561-495-0087
Fax Number	:	561-495-0026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2006
Last Update Date	:	04/21/2016

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Directions to “ DANNI LUTES DRISCOLL MD” Practice Location

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