MEDICARE: DR. DANIEL JOSEPH PRUGAR 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
1	111N00000X	Chiropractor	14446	FL

General Provider Information

NPI Number	:	1770271348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSEPH PRUGAR DC

Provider Business Mailing Address
First Line	:	958 VILLAGE TRL APT 208
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-4728
Country	:	US
Telephone Number	:	410-652-0293
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 DOWNING ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7109
Country	:	US
Telephone Number	:	386-492-7931
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/13/2024

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