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General NPI Number Information
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NPI Number | 1114020559
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Entity Type | Individual
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Provider Name | DANIELE B D'AMBROSIO MPT
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 966 NAUTILUS ISLE
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City | DANIA BEACH
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State | FL
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Zip | 33004-2356
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Country | US
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Telephone | 954-476-5928
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Fax | 954-530-7240
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Provider Business Mailing Address
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Address Line | 966 NAUTILUS ISLE
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City | DANIA BEACH
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State | FL
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Zip | 33004-2356
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Country | US
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Telephone | 954-476-5928
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Fax | 954-530-7240
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17717
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License Number State | FL
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