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General NPI Number Information
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NPI Number | 1932541224
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Entity Type | Individual
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Provider Name | DANIEL DESIRE
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Gender | Male
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Dates
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Enumeration Date | 07/27/2013
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Last Update Date | 07/27/2013
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Provider Practice Location Address
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Address Line | 3600 BROADWAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-4844
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Country | US
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Telephone | 855-888-3247
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Fax |
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Provider Business Mailing Address
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Address Line | 2360 CENTER STONE LN
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-1828
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Country | US
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Telephone | 561-714-6760
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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