Healthcare Provider Details

I. General information

NPI: 1972162543
Provider Name (Legal Business Name): DANIEL ANGERBAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 HARRISON ST STE 404
HOLLYWOOD FL
33020-7829
US

IV. Provider business mailing address

407 LINCOLN RD SUITE 6H PMB 1125
MIAMI BEACH FL
33139-1030
US

V. Phone/Fax

Practice location:
  • Phone: 786-780-1188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME157192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: