DANIEL D DSTTEFFANO (NPI# 1740531011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740531011 |
| Entity Type | Individual |
| Full Name | DANIEL D DSTTEFFANO |
| Credential | MD |
| Practice Address |
212 S Florida St Clark Clinic Inc Bushnell FL 33513-6703 |
| Practice Telephone | 3527932441 |
| Mailing Telephone | 3527932441 |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2014-06-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | ACN543 | FL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 18562 | PR | Allopathic & Osteopathic Physicians |
| Street Address |
212 S FLORIDA ST CLARK CLINIC INC |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467441790 | Vijaya L Nagabhairu | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2005-10-19 |
| 1154893477 | Noelle Mooneyham | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2018-12-27 |
| 1154804615 | Mary Hyacinth Bodenheimer | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2018-09-11 |
| 1669897377 | Ronnie-jane Boekema | Registered Nurse | 212 S Florida St, Bushnell, FL 33513-6703 | 2014-03-04 |
| 1942648803 | Akram Youssef | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2013-06-12 |
| 1306108022 | Yanira Isbet Lara | Family Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2012-06-08 |
| 1992029748 | Victoria A Edelman | Nurse Practitioner | 212 S Florida St, Bushnell, FL 33513-6703 | 2010-03-23 |
| 1255518486 | Ehrentraud Johanna Eichelbaum | General Practice | 212 S Florida St, Bushnell, FL 33513-6703 | 2008-01-30 |
| 1376733857 | Clark Clinic Inc | Clinic/Center | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-31 |
| 1629278882 | Lowell F. Clark Md Pa | Internal Medicine | 212 S Florida St, Bushnell, FL 33513-6703 | 2007-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235696329 | Carefirst Aco, LLC | General Practice | 1225 W County Road 48, Bushnell, FL 33513-8973 | 2019-02-25 |
| 1063414381 | Angel Gabriel Pagan | General Practice | 117 W Belt Ave, Bushnell, FL 33513-5101 | 2005-06-01 |
| 1255518486 | Ehrentraud Johanna Eichelbaum | General Practice | 212 S Florida St, Bushnell, FL 33513-6703 | 2008-01-30 |
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| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.