Healthcare Provider Details

I. General information

NPI: 1508406836
Provider Name (Legal Business Name): DAUD MEDICAL ASSOCIATES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 SE 23RD AVE
BOYNTON BEACH FL
33435-7620
US

IV. Provider business mailing address

14000 S MILITARY TRL STE 104
DELRAY BEACH FL
33484-2600
US

V. Phone/Fax

Practice location:
  • Phone: 561-819-0620
  • Fax: 561-501-5262
Mailing address:
  • Phone: 561-819-0620
  • Fax: 561-501-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JAWAD DAUD
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 561-819-0620