Provider Demographics
NPI:1609883420
Name:FEDER, DANIEL S (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:FEDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18339 NE 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5031
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:NORTH 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?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor