Basic Information
| Provider Information | |||||||||
| NPI: | 1922343599 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIELE MEDICAL EQUIPMENT LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 FORD ST. EXT | ||||||||
| Address2: | UNIT 101 | ||||||||
| City: | FT. MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399367070 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4300 FORD ST. EXT | ||||||||
| Address2: | UNIT 101 | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339169317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399367070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2012 | ||||||||
| LastUpdateDate: | 12/07/2012 | ||||||||
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| AuthorizedOfficialLastName: | DANIELE | ||||||||
| AuthorizedOfficialFirstName: | DOMINIC | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2399367070 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
No ID Information.