Healthcare Provider Details

I. General information

NPI: 1720529209
Provider Name (Legal Business Name): DANIEL JOSIAH DUROCHER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 SW 160TH AVE STE 250
MIRAMAR FL
33027-6314
US

IV. Provider business mailing address

3601 SW 160TH AVE STE 250
MIRAMAR FL
33027-6314
US

V. Phone/Fax

Practice location:
  • Phone: 877-866-7123
  • Fax:
Mailing address:
  • Phone: 877-866-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberOS15821
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS15821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: