Healthcare Provider Details

I. General information

NPI: 1013318468
Provider Name (Legal Business Name): DANIEL CYMBAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 GULF BREEZE PKWY
GULF BREEZE FL
32563-3350
US

IV. Provider business mailing address

537 SIENNA DR
POINCIANA FL
34759-3275
US

V. Phone/Fax

Practice location:
  • Phone: 800-676-5130
  • Fax:
Mailing address:
  • Phone: 407-558-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: