Provider Demographics
NPI:1720183106
Name:DANIEL, NORA LINA (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:LINA
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 SW 176 ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:786-293-3525
Mailing Address - Fax:305-252-0563
Practice Address - Street 1:9299 SW 152 ST
Practice Address - Street 2:200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:305-969-9016
Practice Address - Fax:305-971-0701
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056845208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371663500Medicaid
FL371663500Medicaid