Provider Demographics
NPI:1114736857
Name:DANIEL & MAX, LLC
Entity type:Organization
Organization Name:DANIEL & MAX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-208-1591
Mailing Address - Street 1:1615 S CONGRESS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6326
Mailing Address - Country:US
Mailing Address - Phone:877-350-3399
Mailing Address - Fax:
Practice Address - Street 1:501 N BERKELEY BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3499
Practice Address - Country:US
Practice Address - Phone:877-350-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier