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NPI Code Detail

MEDICARE: MS. DANA MARIE GIBLOCK LCSW

MEDICARE: MS. DANA MARIE GIBLOCK LCSW
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
11041C0700XClinical Social WorkerSW5737FL

General Provider Information

NPI Number : 1568553204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANA MARIE GIBLOCK LCSW
Provider Business Mailing Address
First Line : 150 MAGNOLIA AVE
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-4304
Country : US
Telephone Number : 800-539-4228
Fax Number :
Provider Business Practice Location Address
First Line : 1150 RED JOHN DR BLDG A
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32124-1016
Country : US
Telephone Number : 800-539-4228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 01/12/2026

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