Provider Demographics
NPI:1700874724
Name:BOBER, DANIEL IVAN (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:IVAN
Last Name:BOBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4440 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3535
Mailing Address - Country:US
Mailing Address - Phone:203-232-3189
Mailing Address - Fax:954-272-7848
Practice Address - Street 1:4440 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3535
Practice Address - Country:US
Practice Address - Phone:203-232-3189
Practice Address - Fax:954-272-7848
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS90362084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry