Daniel Gregory Gottlieb, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME109340 Issued in FL

Practice address

790 Dunlawton Ave Ste E
Port Orange, FL 32127-4222

Phone

(386) 760-1877

NPI assigned

Jun 24, 2008

Last updated

Aug 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Health Care Plan, Inc

  dba Florida Health Care Plans Inc.

  • Preferred Provider Organization
  • Daytona Beach, FL
  • NPI 1558302042
  Medicare reassignment NPD
• Florida Health Care Plan, Inc

  dba FHCP ASC - Orange City

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD
• Metcare of Florida, Inc

  dba Conviva Care Center

  • Internal Medicine Physician
  • Hialeah, FL
  • NPI 1902893225
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1417118100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9671",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209671",
            "telephone_number": "386-676-7130",
            "fax_number": "386-676-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 DUNLAWTON AVE STE E",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274222",
            "telephone_number": "386-760-1877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1914 State Road 44",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321688345",
            "country_code": "US",
            "telephone_number": "404-316-0185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "DANIEL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME109340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yarisneisy Gonzalez, APRN
• Jada Gooch
• Mia Goodly
• Ambili Gopinathan Nair, CRNA
• Whitney Gore
• Kathie Gove
• Jeramie Gow, DC
• Alaina Grace
• Kimberley Ann Graef, MS, OTR
• Molly Graham

• Family Medicine Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.