Provider Demographics
NPI:1699771576
Name:PITTS, DAPHNE MARIAN (MD)
Entity type:Individual
Prefix:MS
First Name:DAPHNE
Middle Name:MARIAN
Last Name:PITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13160 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5571
Mailing Address - Country:US
Mailing Address - Phone:954-612-1952
Mailing Address - Fax:
Practice Address - Street 1:14050 NW 14TH ST
Practice Address - Street 2:SUITE 190
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2865
Practice Address - Country:US
Practice Address - Phone:954-475-1300
Practice Address - Fax:954-424-3270
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028451207P00000X
WAMD61344190207P00000X
FLME90371207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269979600Medicaid
F31597Medicare UPIN
FL44804AMedicare PIN