Provider Demographics
NPI:1053621268
Name:HAIMO, DANA (PA-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HAIMO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2100 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:S. 100
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3765
Mailing Address - Country:US
Mailing Address - Phone:954-454-1066
Mailing Address - Fax:954-456-4025
Practice Address - Street 1:2100 E HALLANDALE BEACH BLVD
Practice Address - Street 2:S. 100
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3765
Practice Address - Country:US
Practice Address - Phone:954-454-1066
Practice Address - Fax:954-456-4025
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2022-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105757363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant