Basic Information
Provider Information
NPI: 1245494376
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIEL
FirstName: SAIFU
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 895 ADDISON DR NE
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337163443
CountryCode: US
TelephoneNumber: 7273986661
FaxNumber: 7273989549
Practice Location
Address1: 10000 BAY PINE BLVD
Address2: BAY PINES VA HOSPITAL
City: BAY PINES
State: FL
PostalCode: 33744
CountryCode: US
TelephoneNumber: 7273986661
FaxNumber: 7273989549
Other Information
ProviderEnumerationDate: 07/17/2008
LastUpdateDate: 07/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XME67702FLY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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