Healthcare Provider Details

I. General information

NPI: 1376458729
Provider Name (Legal Business Name): RAUL DANIEL DAYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N MILITARY TRL STE 304
BOCA RATON FL
33431-6324
US

IV. Provider business mailing address

11018 LEGACY DR APT 103
PALM BEACH GARDENS FL
33410-3634
US

V. Phone/Fax

Practice location:
  • Phone: 561-421-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1605126
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: