Provider Demographics
NPI:1386956779
Name:DANCKERS DEGREGORI, MAURICIO (MD)
Entity type:Individual
Prefix:DR
First Name:MAURICIO
Middle Name:
Last Name:DANCKERS DEGREGORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 SW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4021
Mailing Address - Country:US
Mailing Address - Phone:305-484-2852
Mailing Address - Fax:
Practice Address - Street 1:1875 NW CORPORATE BLVD STE 270
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8550
Practice Address - Country:US
Practice Address - Phone:561-997-0821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM121491207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease