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General NPI Number Information
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NPI Number | 1194038307
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Entity Type | Organization
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Legal Business Name | DSS CAPITAL LLC
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 1450 6TH ST SE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-4505
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Country | US
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Telephone | 863-299-1485
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Fax | 863-291-3572
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Provider Business Mailing Address
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Address Line | 4290 S HWY 27 SUITE 201
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City | CLERMONT
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State | FL
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Zip | 34711-8066
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Country | US
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Telephone | 352-536-9270
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Fax | 352-536-9279
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVIAN S SANTANA
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Credential |
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Telephone | 352-516-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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