Provider Demographics
NPI:1699104117
Name:HUDEC, DANIEL JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:HUDEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 W COMMERCIAL BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3429
Mailing Address - Country:US
Mailing Address - Phone:954-714-3612
Mailing Address - Fax:
Practice Address - Street 1:3230 W COMMERCIAL BLVD
Practice Address - Street 2:STE 400
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3429
Practice Address - Country:US
Practice Address - Phone:954-714-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72716208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery