Individual
DR. DERRICK DANIEL THIEL
Active
Individual
DR. DERRICK DANIEL THIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
UO1132
FL
207RI0200X
Infectious Disease Physician
Primary
OS9317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001937700
—
FL
01
—
145RC
BLUE CROSS
—
05
—
1937700
—
FL
Enumeration date
10/11/2006
Last updated
10/12/2012
Update your record
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