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NPI Code Detail

MEDICARE: DR. DANA MARIE GAUS D.C., C.C.N.

MEDICARE: DR. DANA MARIE GAUS D.C., C.C.N.
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
1111NN1001XNutrition ChiropractorCH7831FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00071025OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
155942OTHERFLBCBS

General Provider Information

NPI Number : 1861432643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANA MARIE GAUS D.C., C.C.N.
Provider Business Mailing Address
First Line : 4745 SUTTON PARK CT
Second Line : SUITE 504
City : JACKSONVILLE
State : FL
Zip : 32224-0250
Country : US
Telephone Number : 904-992-0100
Fax Number : 904-992-0111
Provider Business Practice Location Address
First Line : 4745 SUTTON PARK CT
Second Line : SUITE 504
City : JACKSONVILLE
State : FL
Zip : 32224-0250
Country : US
Telephone Number : 904-992-0100
Fax Number : 904-992-0111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 07/08/2007

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