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NPI Code Detail

MEDICARE: DANIEL J VAN DONGEN

MEDICARE: DANIEL J VAN DONGEN
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
1225X00000XOccupational TherapistOT13694FL

General Provider Information

NPI Number : 1609195502
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL J VAN DONGEN
Provider Business Mailing Address
First Line : 1701 N FLAGLER DR APT 214
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-6594
Country : US
Telephone Number : 786-375-7019
Fax Number :
Provider Business Practice Location Address
First Line : 3107 NE 40TH CT
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-6413
Country : US
Telephone Number : 954-454-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2010
Last Update Date : 05/18/2010

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