=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043502883
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARMIN C DAEE D.M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2011
-----------------------------------------------------
Last Update Date | 06/02/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4950 S LE JEUNE RD SUITE B
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-670-1011
-----------------------------------------------------
Fax | 305-670-1012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4950 S LE JEUNE RD SUITE B
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33146-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-670-1011
-----------------------------------------------------
Fax | 305-670-1012
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 19200
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------