| Daniel J Basulto Md Pa | |
|
4578 W 12th Ave Hialeah FL 33012-3325 | |
| (305) 828-1989 | |
| (305) 558-7397 |
| Full Name | Daniel J Basulto Md Pa |
|---|---|
| Speciality | General Practice |
| Location | 4578 W 12th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Daniel J Basulto (PRESIDENT) |
| Authorized Official Contact | 7862528261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel J Basulto Md Pa 9208 Harding Ave Surfside FL 33154-3010 Ph: (786) 252-8261 | Daniel J Basulto Md Pa 4578 W 12th Ave Hialeah FL 33012-3325 Ph: (305) 828-1989 |
| NPI Number | 1407151863 |
|---|---|
| Provider Enumeration Date | 01/17/2011 |
| Last Update Date | 10/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407151863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME81034 (Florida) | Primary |
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