1528049483 NPI number — MR. DANIEL T PARNASSA MD

Table of content: MR. DANIEL T PARNASSA MD (NPI 1528049483)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528049483 NPI number — MR. DANIEL T PARNASSA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARNASSA
Provider First Name:
DANIEL
Provider Middle Name:
T
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528049483
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2227 US HIGHWAY 27 S UNIT 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEBRING
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33870-4936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-385-4300
Provider Business Mailing Address Fax Number:
863-385-0383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2227 US HIGHWAY 27 S UNIT 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEBRING
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33870-4936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-385-4300
Provider Business Practice Location Address Fax Number:
863-385-0383
Provider Enumeration Date:
11/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  ME78117 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 266296500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00073719 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 892750856 . This is a "CLINICIAN PROVIDER ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0224610 . This is a "HEALTHEASE/HEALTHY KIDS PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: N224610 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 62805 . This is a "BLUE CROSS BLUE SHIELD OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 105774800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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