Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME34257 | FL |
N | 111NI0900X | Internist | ME34257 | FL |
N | 208D00000X | General Practice Physician | ME34257 | FL |
NPI | 1013966704 |
---|---|
Provider Name | Daniel F Mandri |
First Address | Miami, FL 33193-5828 |
Second Address | Miami, FL 33193-5828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 25/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066441300 | (05) | FL |
D63628 | (02) |