MEDICARE: DANIEL KESSLER DO

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	207Q00000X	Family Medicine Physician	OS10198	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

General Provider Information

NPI Number	:	1306003025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL KESSLER DO

Provider Business Mailing Address
First Line	:	PO BOX 551308
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32255-1308
Country	:	US
Telephone Number	:	904-622-9035
Fax Number	:	904-493-2222

Provider Business Practice Location Address
First Line	:	9759 SAN JOSE BLVD
Second Line	:	BUILDING 2
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-4401
Country	:	US
Telephone Number	:	904-622-9035
Fax Number	:	904-493-2222

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

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	07/08/2015

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