Individual
GARY C DANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1958 DAIRY RD, MELBOURNE, FL 32904-4045
(321) 409-0010
(321) 676-1327
Mailing address
1958 DAIRY RD, MELBOURNE, FL 32904-4045
(321) 409-0010
(321) 676-1327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME64854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080075532
RR MEDICARE
FL
01
—
25046
BCBS
FL
05
—
376190800
—
FL
01
—
IM329Z
MEDICARE
FL
Enumeration date
10/26/2005
Last updated
01/11/2019
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