MEDICARE: W. PATRICK DANZEY, D.C.P.A.

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	111NI0013X	Independent Medical Examiner Chiropractor

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

General Provider Information

NPI Number	:	1194031732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. PATRICK DANZEY, D.C.P.A.

Provider Business Mailing Address
First Line	:	1590 US 27 N
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-2151
Country	:	US
Telephone Number	:	863-453-5777
Fax Number	:	863-453-9737

Provider Business Practice Location Address
First Line	:	1590 US 27 N
Second Line	:
City	:	AVON PARK
State	:	FL
Zip	:	33825-2151
Country	:	US
Telephone Number	:	863-453-5777
Fax Number	:	863-453-9737

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM PATRICK DANZEY
Credential	:	D.C.P.A.
Telephone Number	:	863-453-5777

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	07/06/2012

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