Provider Demographics
NPI:1093846040
Name:CUADRA, DANIEL BENJAMIN JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:BENJAMIN
Last Name:CUADRA
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8406 SW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3259
Mailing Address - Country:US
Mailing Address - Phone:305-205-1532
Mailing Address - Fax:
Practice Address - Street 1:8600 NW 107TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3921
Practice Address - Country:US
Practice Address - Phone:305-805-1900
Practice Address - Fax:305-805-1901
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer