Provider Demographics
NPI:1821597618
Name:DANIEL PETERS MD PA
Entity Type:Organization
Organization Name:DANIEL PETERS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-626-2914
Mailing Address - Street 1:11211 PROSPERITY FARMS RD STE B105
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3471
Mailing Address - Country:US
Mailing Address - Phone:561-626-2914
Mailing Address - Fax:561-626-2915
Practice Address - Street 1:11211 PROSPERITY FARMS RD STE B105
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3471
Practice Address - Country:US
Practice Address - Phone:561-626-2914
Practice Address - Fax:561-626-2915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86916207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty