Healthcare Provider Details

I. General information

NPI: 1700377827
Provider Name (Legal Business Name): DANIEL DUTRA CAVALCANTI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

755 E MCDOWELL RD FL 2
PHOENIX AZ
85006-2506
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-2000
  • Fax:
Mailing address:
  • Phone: 602-521-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number79292
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: