Healthcare Provider Details
I. General information
NPI: 1134434319
Provider Name (Legal Business Name): MACARIUS & DANIEL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2010
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4302 E WASHINGTON AVE
MADISON WI
53704-3722
US
IV. Provider business mailing address
1615 S CONGRESS AVE STE 105
DELRAY BEACH FL
33445-6326
US
V. Phone/Fax
- Phone: 608-241-1600
- Fax: 561-275-2020
- Phone: 561-275-2020
- Fax: 561-275-2002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIRSTEN
PIPHER
CANTRELL
Title or Position: MANAGER OF HEALTH SERVICES
Credential:
Phone: 561-208-8464