MEDICARE: DANIEL PRIDHAM

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	101Y00000X	Counselor	IMH28776	FL

General Provider Information

NPI Number	:	1972436129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL PRIDHAM

Provider Business Mailing Address
First Line	:	379 TIDEWATER DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	379 TIDEWATER DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7226
Country	:	US
Telephone Number	:	904-210-6666
Fax Number	:

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

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

Similar Medicare Providers

1699149757 — PERMA CARE ASSISTED LIVING FACILITY, LLC
Practice Location Address:

7226 EUDINE DR S
JACKSONVILLE, FL
32210-2633

Practice Phone: 904-723-1885
Practice Fax:

1811451073 — CHRISTINE MAXIMOS OTR/L
Practice Location Address:

13836 CYRUS CT
JACKSONVILLE, FL
32224-7226

Practice Phone: 908-436-7517
Practice Fax:

1487246088 — ELEVATION REHAB, LLC
Practice Location Address:

13836 CYRUS CT
JACKSONVILLE, FL
32224-7226

Practice Phone: 908-436-7517
Practice Fax:

1194415307 — MRS. MADISON CLAIRE SCHURB DMD
Practice Location Address:

5491 DOLPHIN POINT BLVD
JACKSONVILLE, FL
32211-3221

Practice Phone: 601-549-1811
Practice Fax:

1104981398 — JACKSONVILLE PRIMARY CARE PA
Practice Location Address:

8016 ATLANTIC BLVD
JACKSONVILLE, FL
32211-8751

Practice Phone: 904-838-7581
Practice Fax:

1962567156 — CICERON LAZO MD
Practice Location Address:

8016 ATLANTIC BLVD
JACKSONVILLE, FL
32211-8751

Practice Phone: 904-619-8687
Practice Fax:

Directions to “ DANIEL PRIDHAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.