Provider Demographics
NPI:1578540977
Name:DEANE, DANIEL DAVID (MSPT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DAVID
Last Name:DEANE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1814 NE MIAMI GARDENS DR
Mailing Address - Street 2:#407
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5043
Mailing Address - Country:US
Mailing Address - Phone:305-466-5665
Mailing Address - Fax:305-466-8580
Practice Address - Street 1:18339 NE 19TH AVE
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5031
Practice Address - Country:US
Practice Address - Phone:305-466-5665
Practice Address - Fax:305-466-8580
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2962XMedicare UPIN