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Organization

DANIEL ETTEDGUI, D.O. PA

Active
Other names
Physical Medicine of South Florida
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. FLORI F MCGINTY (PRACTICE ADMINISTRATOR)
(561) 912-9580
Entity
Organization

Contact information

Practice address
1905 CLINT MOORE ROAD, SUITE 308, BOCA RATON, FL 33496-2658
(561) 912-9580
(561) 912-9506
Mailing address
1905 CLINT MOORE ROAD, SUITE 308, BOCA RATON, FL 33496
(561) 912-9580
(561) 912-9506

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS-6221
FL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
OS6221
FL

Other

Enumeration date
10/24/2006
Last updated
04/13/2012
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