NPI: 1467090639 · ORANGE PARK, FL 32065 · Primary Podiatric Medicine Podiatrist · NPI assigned 12/18/2019
| Authorized Official | DANIELS, DEDRICK (PRESIDENT) |
| NPI Enumeration Date | 12/18/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 20 | $1.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 11721 | 20 | 13 | $1.00 |