Provider Demographics
NPI:1346414166
Name:DD MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:DD MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-972-0313
Mailing Address - Street 1:330 SW 27TH AVE
Mailing Address - Street 2:STE 606
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2961
Mailing Address - Country:US
Mailing Address - Phone:786-294-0808
Mailing Address - Fax:786-294-0909
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:STE 606
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:786-294-0808
Practice Address - Fax:786-294-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 6815208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty