Provider Demographics
NPI:1639782774
Name:CARVAJAL, DANIEL GIOVANNIE (RPH)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GIOVANNIE
Last Name:CARVAJAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 NE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-5021
Mailing Address - Country:US
Mailing Address - Phone:305-245-0395
Mailing Address - Fax:
Practice Address - Street 1:861 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-5021
Practice Address - Country:US
Practice Address - Phone:305-245-0395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist