=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588540058
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIEL & MAX, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2025
-----------------------------------------------------
Last Update Date | 08/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 W NAVAJO DR UNIT 400
-----------------------------------------------------
City | HOBBS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-350-3399
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1615 S CONGRESS AVE
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33445-6300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-350-3399
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REVENUE CYCLE MANAGER
-----------------------------------------------------
Name | ALISHA JACKSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-208-1591
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------