Provider Demographics
NPI:1275734766
Name:CHAN, DANIEL BAYON (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BAYON
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:2122 W CYPRESS CREEK RD STE 220
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1868
Practice Address - Country:US
Practice Address - Phone:954-265-7700
Practice Address - Fax:954-276-0435
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2021-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME103982207XX0801X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010966900Medicaid
FLDI604YOtherMEDICARE PTAN