Individual
MR. DANIEL LE PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 PRUDENTIAL DR FL 32207, JACKSONVILLE, FL 32207-8202
(904) 202-2000
Mailing address
2220 TALL GRASS AVE, BARTOW, FL 33830-2945
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
589
FL
Other
Enumeration date
05/08/2020
Last updated
10/04/2020
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