MEDICARE: DANIELA DADURIAN M.D.

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	207R00000X	Internal Medicine Physician	ME70074	FL

General Provider Information

NPI Number	:	1134126469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA DADURIAN M.D.

Provider Business Mailing Address
First Line	:	320 S QUADRILLE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5305
Country	:	US
Telephone Number	:	561-366-9773
Fax Number	:	561-366-8665

Provider Business Practice Location Address
First Line	:	320 S QUADRILLE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5305
Country	:	US
Telephone Number	:	561-366-9773
Fax Number	:	561-366-8665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	11/12/2011

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