=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548560196
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REYNALDO DACO MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2010
-----------------------------------------------------
Last Update Date | 06/13/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 W KALEY ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32806-2931
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-843-3637
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 W KALEY ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32806-2931
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-843-3637
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. REYNALDO DACO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-843-3637
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | ME27336
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------