Provider Demographics
NPI:1649336660
Name:DANET, MARIANA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:
Last Name:DANET
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 1:1666 BUNTING LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2000
Mailing Address - Country:US
Mailing Address - Phone:954-317-3930
Mailing Address - Fax:954-543-5250
Practice Address - Street 1:600 N HIATUS RD
Practice Address - Street 2:SUITE #201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5207
Practice Address - Country:US
Practice Address - Phone:954-317-3930
Practice Address - Fax:954-543-5250
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME909792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271760300Medicaid
FL271760300Medicaid
FL50042YMedicare ID - Type Unspecified