Provider Demographics
NPI:1316928500
Name:CARNEY, DANIEL CHARLES SR (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHARLES
Last Name:CARNEY
Suffix:SR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740463
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-0463
Mailing Address - Country:US
Mailing Address - Phone:561-734-7598
Mailing Address - Fax:561-739-5136
Practice Address - Street 1:3487 NW 30TH ST
Practice Address - Street 2:ST ANTHONY'S REHABILITATION HOSPITAL
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-1103
Practice Address - Country:US
Practice Address - Phone:954-739-6233
Practice Address - Fax:954-343-3484
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83788208100000X, 208M00000X
FLDS7308208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC837885Medicaid
FL266332500Medicaid
FL266332500Medicaid