Provider Demographics
NPI:1619404886
Name:BUCHIN, DANIEL ALEXANDER (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALEXANDER
Last Name:BUCHIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:BUCHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3720 INVERRARY DR APT 2K
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:729 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6345
Practice Address - Country:US
Practice Address - Phone:954-943-5044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9114175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant