Provider Demographics
NPI:1013300409
Name:LONG, DANIEL STEVEN (DPT OCS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STEVEN
Last Name:LONG
Suffix:
Gender:M
Credentials:DPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S DOUGLAS RD STE 908
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6142
Mailing Address - Country:US
Mailing Address - Phone:786-423-3437
Mailing Address - Fax:
Practice Address - Street 1:2600 S DOUGLAS RD STE 908
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6142
Practice Address - Country:US
Practice Address - Phone:786-423-3437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 30153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist