Basic Information
| Provider Information | |||||||||
| NPI: | 1619430790 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KITNER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9862 BEACH PORT DR | ||||||||
| Address2: | |||||||||
| City: | WINTER GARDEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347874493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543719845 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16106 MARSH RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | WINTER GARDEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347879182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076353090 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2019 | ||||||||
| LastUpdateDate: | 06/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME151685 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | ME151685 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.