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Individual

DAYLAN FREDRICK HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1320 NE 200TH TER, MIAMI, FL 33179-5138
(305) 785-4864
Mailing address
1320 NE 200TH TER, MIAMI, FL 33179-5138
(305) 785-4864

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
687028
APPLICATION TRACKING NUMBER
FL
05
687028
FL
Enumeration date
10/10/2017
Last updated
10/10/2017
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