Provider Demographics
NPI:1396753992
Name:O'HARA, DANIEL E (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:O'HARA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:660 GLADES RD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6465
Mailing Address - Country:US
Mailing Address - Phone:561-393-1994
Mailing Address - Fax:561-393-2445
Practice Address - Street 1:660 GLADES RD
Practice Address - Street 2:SUITE 380
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6465
Practice Address - Country:US
Practice Address - Phone:561-393-1994
Practice Address - Fax:561-393-2445
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME83775208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG51742Medicare UPIN