Basic Information
| Provider Information | |||||||||
| NPI: | 1316928500 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARNEY | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 740463 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334740463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617347598 | ||||||||
| FaxNumber: | 5617395136 | ||||||||
| Practice Location | |||||||||
| Address1: | 3487 NW 30TH ST | ||||||||
| Address2: | ST ANTHONY'S REHABILITATION HOSPITAL | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333111103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547396233 | ||||||||
| FaxNumber: | 9543433484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 11/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 83788 | SC | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208M00000X | 83788 | SC | N | Allopathic & Osteopathic Physicians | Hospitalist | 208100000X | DS7308 | FL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 837885 | 05 | SC | MEDICAID | 266332500 | 05 | FL | MEDICAID |