Provider Demographics
NPI:1649587908
Name:URDANETA, DANIEL ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ENRIQUE
Last Name:URDANETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:280 WEKIVA SPRINGS RD STE 1000
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6098
Practice Address - Country:US
Practice Address - Phone:407-788-2273
Practice Address - Fax:407-389-2273
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME120984208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice