MEDICARE: ANTOINE I DAKOUNY 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	207R00000X	Internal Medicine Physician	ME 95166	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	ME95166	OTHER	FL	LICENSE NUMBER
3	92828	OTHER	FL	BCBS FL

General Provider Information

NPI Number	:	1538232384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINE I DAKOUNY MD

Provider Business Mailing Address
First Line	:	3400 TAMIAMI TRL
Second Line	:	SUITE 104
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8102
Country	:	US
Telephone Number	:	941-624-4507
Fax Number	:	941-624-4506

Provider Business Practice Location Address
First Line	:	3400 TAMIAMI TRL
Second Line	:	SUITE 104
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8102
Country	:	US
Telephone Number	:	941-624-4507
Fax Number	:	941-624-4506

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	03/26/2010

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Directions to “ ANTOINE I DAKOUNY MD” Practice Location

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