Provider Demographics
NPI:1346580933
Name:NIMMO, DANIEL KENT (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:KENT
Last Name:NIMMO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 W LAS OLAS BLVD
Mailing Address - Street 2:1512
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20900 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1407
Practice Address - Country:US
Practice Address - Phone:305-682-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5418207L00000X
FLOS 14102207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5418OtherMEDICAL LICENSE
FLOS 14102OtherOSTEOPATHIC MEDICAL BOARD
OK47096OtherOK BOARD OF NARCOTICS AND DANGEROUS DRUGS CONTROL
OK47096OtherOK BOARD OF NARCOTICS AND DANGEROUS DRUGS CONTROL