Provider Demographics
NPI:1932507407
Name:DANIELS, EDWARD III (CERTIFIED PEDORTHIST)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:DANIELS
Suffix:III
Gender:M
Credentials:CERTIFIED PEDORTHIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E OAKLAND PARK BLVD
Mailing Address - Street 2:369
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2148
Mailing Address - Country:US
Mailing Address - Phone:954-915-4911
Mailing Address - Fax:
Practice Address - Street 1:300 E OAKLAND PARK BLVD
Practice Address - Street 2:369
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-2148
Practice Address - Country:US
Practice Address - Phone:954-915-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist