Provider Demographics
NPI:1548562051
Name:BOLET, DANIEL EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDUARDO
Last Name:BOLET
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 1:1500 NW 12TH AVE STE 810
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1037
Mailing Address - Country:US
Mailing Address - Phone:305-585-6649
Mailing Address - Fax:
Practice Address - Street 1:3801 BISCAYNE BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-9800
Practice Address - Country:US
Practice Address - Phone:786-466-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117082207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology