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Provider Information for 1932131109

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DANIEL SANTO MAZZARELLA DMD

Gender: MALE

Individual NPI: 1932131109

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1932131109
Enumeration Date 2006-07-07
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2050 NW 76TH TER
PEMBROKE PINES, FL 33024-0928
United States

Phone: 954-893-6109 | Fax:
View Map External Link
Primary Practice Address 1201 NW 16TH ST
MIAMI, FL 33125-1624
United States

Phone: 305-575-3146 | Fax: 305-575-3373
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice FL DN14338