MEDICARE: DANIEL & MAX, LLC

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
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1063355592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL & MAX, LLC

Provider Business Mailing Address
First Line	:	1615 S CONGRESS AVE STE 105
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7290 FAIRLANE VILLAGE MALL
Second Line	:
City	:	POTTSVILLE
State	:	PA
Zip	:	17901-4105
Country	:	US
Telephone Number	:	570-628-4707
Fax Number	:	570-628-5790

Authorized Official
Title or Position	:	MANAGED CARE MANAGER
Name	:	ALISHA JACKSON
Credential	:
Telephone Number	:	561-208-1591

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “DANIEL & MAX, LLC ” Practice Location

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