Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME104329 | FL |
N | 2081P2900X | Pain Medicine | ME 104329 | FL |
NPI | 1396920161 |
---|---|
Provider Name | Dr. Daniel R Marin |
First Address | Miami, FL 33156-7378 |
Second Address | Miami, FL 33156-7378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2007 |
Last Update Date | 31/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000979500 | (05) | FL |
145RW | BLUE CROSS BLUE SHIELD (01) | FL |