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General NPI Number Information
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NPI Number | 1093265191
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Entity Type | Organization
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Legal Business Name | DANIEL MAX & MARC ANDREA LLC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 7580 W COMMERCIAL BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33319-2132
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Country | US
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Telephone | 754-312-3857
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Fax | 561-828-8367
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Provider Business Mailing Address
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Address Line | 3801 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33461-4140
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Country | US
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Telephone | 561-275-2020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL STANTON
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Credential |
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Telephone | 561-275-2020
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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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