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Individual

DANIEL MCDONOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1304 OAK ST, MELBOURNE, FL 32901-3111
(321) 723-4723
(321) 727-1448
Mailing address
1304 OAK ST, MELBOURNE, FL 32901-3111
(321) 723-4723
(321) 727-1448

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
418799
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
307957100
FL
01
G4083
BCBSFL
FL
Enumeration date
08/02/2006
Last updated
06/12/2008
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