MEDICARE: DR. DANIEL LAI 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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	MT192814	PA
2	2084N0400X	Neurology Physician	35123456	OH
3	2084N0600X	Clinical Neurophysiology Physician	35123456	OH
4	2084N0400X	Neurology Physician	ME129764	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	H333510	OTHER	OH	MEDICARE PTAN

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
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497989800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL LAI MD

Provider Business Mailing Address
First Line	:	240 N WICKHAM RD STE 309
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-8661
Country	:	US
Telephone Number	:	321-752-1630
Fax Number	:	321-690-6578

Provider Business Practice Location Address
First Line	:	240 N WICKHAM RD STE 309
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-8661
Country	:	US
Telephone Number	:	321-752-1630
Fax Number	:	321-690-6578

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	04/01/2025

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Directions to “ DR. DANIEL LAI MD” Practice Location

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