Provider Demographics
NPI:1912346123
Name:PIETRAS, DANIEL ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTHONY
Last Name:PIETRAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 NW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2568
Mailing Address - Country:US
Mailing Address - Phone:632-618-3548
Mailing Address - Fax:863-824-7511
Practice Address - Street 1:2151 45TH ST STE 210
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2015
Practice Address - Country:US
Practice Address - Phone:863-261-8354
Practice Address - Fax:863-638-5637
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01080903A2084P0800X
FLME1284952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry