Healthcare Provider Details

I. General information

NPI: 1427372267
Provider Name (Legal Business Name): JOSHUA DAVID DALY HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 S ORANGE BLOSSOM TRL STE 692
ORLANDO FL
32809-9135
US

IV. Provider business mailing address

8001 S ORANGE BLOSSOM TRL STE 692
ORLANDO FL
32809-9135
US

V. Phone/Fax

Practice location:
  • Phone: 407-859-7005
  • Fax: 407-850-2635
Mailing address:
  • Phone: 407-859-7005
  • Fax: 407-850-2635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS4642
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: