Provider Demographics
NPI:1235337411
Name:DANIEL BRANDWEIN DPM P A
Entity Type:Organization
Organization Name:DANIEL BRANDWEIN DPM P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRANDWEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-984-7500
Mailing Address - Street 1:159 S POMPANO PKWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3003
Mailing Address - Country:US
Mailing Address - Phone:954-984-7500
Mailing Address - Fax:954-984-8884
Practice Address - Street 1:159 S POMPANO PKWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3003
Practice Address - Country:US
Practice Address - Phone:954-984-7500
Practice Address - Fax:954-984-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65751OtherBCBS OF FL
DG7058OtherMEDICARE RAILROAD
FL340568100Medicaid
FLAF098Medicare PIN
FLU20259Medicare UPIN
FL4607780001Medicare NSC