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General NPI Number Information
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NPI Number | 1962543835
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Entity Type | Individual
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Provider Name | DANILO THALES DORMEUS RRT
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15300 NE 5TH AVE
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City | MIAMI
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State | FL
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Zip | 33162-5052
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Country | US
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Telephone | 305-947-9823
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Fax | 305-987-9823
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Provider Business Mailing Address
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Address Line | 15300 NE 5TH AVE
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City | MIAMI
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State | FL
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Zip | 33162-5052
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Country | US
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Telephone | 305-947-9823
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Fax | 305-987-9823
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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 | 2279G1100X
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Taxonomy Name | General Care Registered Respiratory Therapist
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License Number | RT005405
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License Number State | FL
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