Provider Demographics
NPI:1225034341
Name:SHELDON, DANIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:SHELDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:STE 213
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-659-0115
Mailing Address - Fax:954-659-0665
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:STE 213
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-659-0115
Practice Address - Fax:954-659-0665
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069381207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5817490001OtherDMERC
FL255944700Medicaid
FL255944700Medicaid