Provider Demographics
NPI:1588908248
Name:GAUTREAUX, DANIEL AMAURI (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:AMAURI
Last Name:GAUTREAUX
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 1:5132 SW 129TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5839
Mailing Address - Country:US
Mailing Address - Phone:305-331-7596
Mailing Address - Fax:
Practice Address - Street 1:730 NW 107TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3104
Practice Address - Country:US
Practice Address - Phone:786-636-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker