MEDICARE: DANIEL MAX & MARCANDREA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1881023372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL MAX & MARCANDREA, LLC

Provider Business Mailing Address
First Line	:	3801 S CONGRESS AVE
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-4140
Country	:	US
Telephone Number	:	561-275-2020
Fax Number	:	561-275-2030

Provider Business Practice Location Address
First Line	:	10520 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1509
Country	:	US
Telephone Number	:	786-501-7085
Fax Number	:	561-828-8367

Authorized Official
Title or Position	:	CEO
Name	:	DANIEL STANTON
Credential	:
Telephone Number	:	561-275-2020

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	02/19/2021

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