Provider Demographics
NPI:1427307008
Name:HLAVACEK, DANIEL LEONARD (CCDS)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:LEONARD
Last Name:HLAVACEK
Suffix:
Gender:M
Credentials:CCDS
Other - Prefix:
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Mailing Address - Street 1:3967 EAST HERRERA DRIVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050
Mailing Address - Country:US
Mailing Address - Phone:602-321-7680
Mailing Address - Fax:480-704-3471
Practice Address - Street 1:3967 EAST HERRERA DRIVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:602-321-7680
Practice Address - Fax:480-704-3471
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology