Healthcare Provider Details

I. General information

NPI: 1346539129
Provider Name (Legal Business Name): DANIEL H BUITRAGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NW 9TH AVE
MIAMI FL
33136-1101
US

IV. Provider business mailing address

1801 NW 9TH AVE
MIAMI FL
33136-1101
US

V. Phone/Fax

Practice location:
  • Phone: 305-355-5000
  • Fax: 305-355-2300
Mailing address:
  • Phone: 305-355-5000
  • Fax: 305-355-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberME164958
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code335U00000X
TaxonomyOrgan Procurement Organization
License NumberME164958
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME164958
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: