Provider Demographics
NPI:1649255993
Name:WASSERMAN, DANIEL A (DOM)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
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Mailing Address - Street 1:3702 WASHINGTON ST
Mailing Address - Street 2:STE 101
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8282
Mailing Address - Country:US
Mailing Address - Phone:954-272-2225
Mailing Address - Fax:954-272-0554
Practice Address - Street 1:3702 WASHINGTON ST
Practice Address - Street 2:STE 101
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8282
Practice Address - Country:US
Practice Address - Phone:954-272-2225
Practice Address - Fax:954-272-0554
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP1191171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist