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Individual

DARIA P MCDONOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
284 N HALIFAX DR, ORMOND BEACH, FL 32176-5765
(386) 672-9932
(386) 672-4201
Mailing address
PO BOX 4211, ORMOND BEACH, FL 32175-4211
(386) 672-9932
(386) 672-4201

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P0978
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340437400
FL
01
480014083
RAILROAD MEDICARE
Enumeration date
09/21/2005
Last updated
11/14/2014
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