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NPI Code Detail

MEDICARE: DAHER ANTONIO QUEIROZ DDS, MS, PHD

MEDICARE: DAHER ANTONIO QUEIROZ DDS, MS, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDTP877FL
21223P0700XProsthodontics38228TX

General Provider Information

NPI Number : 1013657576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAHER ANTONIO QUEIROZ DDS, MS, PHD
Provider Business Mailing Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 954-262-7213
Fax Number :
Provider Business Practice Location Address
First Line : 3200 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-2018
Country : US
Telephone Number : 954-262-7213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2022
Last Update Date : 05/20/2026

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