Provider Demographics
NPI:1316176506
Name:WILSON, DAISY M (RESPIRATORY THERAPY)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:M
Last Name:WILSON
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PINE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4100
Mailing Address - Country:US
Mailing Address - Phone:561-967-9723
Mailing Address - Fax:
Practice Address - Street 1:508 PINE CIR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4100
Practice Address - Country:US
Practice Address - Phone:561-967-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT13721227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified