Provider Demographics
NPI:1417951088
Name:ELIZONDO, DANIEL RICARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RICARDO
Last Name:ELIZONDO
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 1:8901 WISCONSIN AVENUE
Mailing Address - Street 2:OPHTHALMOLOGY DEPARTMENT
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5000
Mailing Address - Country:US
Mailing Address - Phone:301-295-1339
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVENUE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5000
Practice Address - Country:US
Practice Address - Phone:301-295-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8019207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology