Individual
DR. DANIEL J MOUNTCASTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5901 SUN BLVD, SUITE 113-A, ST PETERSBURG, FL 33715-1166
(727) 865-6941
(727) 867-2639
Mailing address
5901 SUN BLVD, SUITE 113-A, ST PETERSBURG, FL 33715-1166
(727) 865-6941
(727) 867-2639
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
ME36289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039342800
—
FL
01
—
ME36289
MEDICAL LICENSE NUMBER
FL
Enumeration date
09/28/2006
Last updated
11/13/2014
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