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NPI Code Detail

MEDICARE: DR. DANIEL LOUIS AXELROD M.D.

MEDICARE: DR. DANIEL LOUIS AXELROD M.D.
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
1207R00000XInternal Medicine PhysicianME75352FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
243731OTHERFLBC BS PROVIDER #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194723569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL LOUIS AXELROD M.D.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number : 239-599-2612
Provider Business Practice Location Address
First Line : 13813 METRO PKWY
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4343
Country : US
Telephone Number : 239-936-1343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 01/19/2023

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