Provider Demographics
NPI:1154941847
Name:DANIELS, CHELSEA KAGAN (MD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:KAGAN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 NW 161ST ST FL 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6314
Mailing Address - Country:US
Mailing Address - Phone:305-830-4111
Mailing Address - Fax:305-830-4110
Practice Address - Street 1:585 NW 161ST ST FL 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6314
Practice Address - Country:US
Practice Address - Phone:305-830-4111
Practice Address - Fax:305-830-4110
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-02665207Q00000X
VA0101278232207Q00000X
FLME161899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine