Healthcare Provider Details

I. General information

NPI: 1073417663
Provider Name (Legal Business Name): DANIEL & MAX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17768 NW 57TH AVE
HIALEAH FL
33015-5118
US

IV. Provider business mailing address

1615 S CONGRESS AVE STE 105
DELRAY BEACH FL
33445-6326
US

V. Phone/Fax

Practice location:
  • Phone: 877-350-3399
  • Fax: 561-828-8367
Mailing address:
  • Phone: 561-208-1591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALISHA JACKSON
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 561-208-1591