Doctor Name: | DR. DANIEL M CONRADO |
NPI Number: | 1114910221 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME0024802 |
Business Practice Address: | 4423 Park Blvd N Pinellas Park, FL - 337813540 |
Business Phone Number: | 7278272825 |
Business Fax Number: | 7278272809 |
Mailing Address: | 4423 Park Blvd N, PINELLAS PARK |
State: | FL |
Postal Code: | 337813540 |
Phone Number: | 7278272825 |
Fax Number: | 7278272809 |
NPI Enumeration Date: | 08/24/2005 |
NPI Last Update Date: | 04/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME0024802 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |