Healthcare Provider Details

I. General information

NPI: 1114989605
Provider Name (Legal Business Name): DANIEL NADER DARIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10625 N MILITARY TRL STE 102
PALM BEACH GARDENS FL
33410-6548
US

IV. Provider business mailing address

10625 N MILITARY TRL STE 102
PALM BEACH GARDENS FL
33410-6548
US

V. Phone/Fax

Practice location:
  • Phone: 561-249-7626
  • Fax: 561-249-7713
Mailing address:
  • Phone: 561-249-7626
  • Fax: 561-249-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME94898
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: