1235349531 NPI number — DANIEL A PICARD MD PA

Table of content: (NPI 1235349531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235349531 NPI number — DANIEL A PICARD MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL A PICARD MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235349531
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33482-7120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-381-3425
Provider Business Mailing Address Fax Number:
888-491-6291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2815 S SEACREST BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOYNTON BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33435-7934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-381-3425
Provider Business Practice Location Address Fax Number:
888-491-6291
Provider Enumeration Date:
05/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PICARD
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-381-3425

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  ME61639 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1287004 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 15029 . This is a "BCBS FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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