MEDICARE: DR. DANIEL RAYMOND FARRELL 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
1	207Q00000X	Family Medicine Physician	35807	IA
2	207P00000X	Emergency Medicine Physician	ME99257	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	:	1386642924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL RAYMOND FARRELL M.D.

Provider Business Mailing Address
First Line	:	12014 W BAYSHORE DR
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-9261
Country	:	US
Telephone Number	:	407-620-0211
Fax Number	:	352-220-6463

Provider Business Practice Location Address
First Line	:	12014 W BAYSHORE DR
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-9261
Country	:	US
Telephone Number	:	407-620-0211
Fax Number	:	352-220-6463

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	09/22/2009

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Directions to “ DR. DANIEL RAYMOND FARRELL M.D.” Practice Location

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