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General NPI Number Information
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NPI Number | 1023444536
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Entity Type | Organization
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Legal Business Name | DANIEL, MAX & MARCANDREA
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 741 N UNIVERSITY DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7000
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Country | US
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Telephone | 954-228-8090
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Fax | 561-828-8367
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Provider Business Mailing Address
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Address Line | 1615 S CONGRESS AVE STE 105
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6326
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Country | US
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Telephone | 561-275-2020
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Fax | 561-275-2030
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Authorized Official
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Title or Position | MANAGED CARE MANAGER
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Name | ALISHA JACKSON
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Credential |
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Telephone | 561-208-1591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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