Provider Demographics
NPI:1679561849
Name:BRANDWEIN, DANIEL S (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:BRANDWEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 S POMPANO PKWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3003
Mailing Address - Country:US
Mailing Address - Phone:954-984-7500
Mailing Address - Fax:954-984-8884
Practice Address - Street 1:159 S POMPANO PKWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3003
Practice Address - Country:US
Practice Address - Phone:954-984-7500
Practice Address - Fax:954-984-8884
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP02443213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340568100Medicaid
FL480034654OtherRAILROAD MEDICARE
FL65751OtherBCBS OF FL
FL4607780001Medicare NSC
U20259Medicare UPIN
FL340568100Medicaid