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NPI Code Detail

MEDICARE: DR. ERIC JEFFERY DANIEL DC

MEDICARE: DR. ERIC JEFFERY DANIEL DC
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
1111N00000XChiropractor13637FL

General Provider Information

NPI Number : 1508438730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC JEFFERY DANIEL DC
Provider Business Mailing Address
First Line : 6645 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-853-3000
Fax Number : 863-859-7640
Provider Business Practice Location Address
First Line : 6645 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-393-6913
Fax Number : 863-859-7640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2021
Last Update Date : 04/13/2022

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