Provider Demographics
NPI:1710584537
Name:BECK, DANIEL (FNP)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BECK
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 VIA REGINA
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3910
Mailing Address - Country:US
Mailing Address - Phone:954-816-9903
Mailing Address - Fax:
Practice Address - Street 1:6511 VIA REGINA
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3910
Practice Address - Country:US
Practice Address - Phone:954-816-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine