Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN20152 | FL |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN20152 | FL |
NPI | 1023437233 |
---|---|
Provider Name | Daniel Berenstein |
First Address | Hollywood, FL 33021-2531 |
Second Address | Hollywood, FL 33021-2531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 15/08/2019 |