Individual
MR. DANIEL S KREISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
811 N SUMMIT ST, CRESCENT CITY, FL 32112-2191
(386) 698-2279
(386) 698-2239
Mailing address
185 KINGFISH RD, POMONA PARK, FL 32181-2424
(386) 649-3004
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 0003478
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290543400
—
FL
01
—
PA0003478
FL LICENSE
FL
Enumeration date
01/10/2007
Last updated
07/08/2010
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