Provider Demographics
NPI:1194715227
Name:SCHAFFER, DANIEL (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 CITRUS TOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6699
Mailing Address - Country:US
Mailing Address - Phone:352-559-0979
Mailing Address - Fax:352-708-3050
Practice Address - Street 1:2749 CITRUS TOWER BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-559-0979
Practice Address - Fax:352-708-3050
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93585208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273834100Medicaid
FL28711ZMedicare ID - Type Unspecified
FL273834100Medicaid